How do I choose an oropharyngeal airway?

How do I choose an oropharyngeal airway?

When determining the appropriate oropharyngeal size for a patient, one must assess where the oropharyngeal airway parts lie in relation to the patient’s anatomical landmarks. The flange should be approximated, externally, to where it is abutting the lips, and the tip should be able to reach the angle of the mandible.

What is the correct method of sizing an oropharyngeal airway for an infant or child?

To find the best size for your child, trace an imaginary line on one side of the face from one corner of child’s mouth to the earlobe. Place the device on child’s face along this line. The OP airway is the correct length if it reaches from the corner of mouth to the earlobe.

When is an oropharyngeal airway used?

Oropharyngeal airway devices are often used as “bite blocks” after a patient’s trachea has been intubated, in order to prevent the clenching of the teeth on the endotracheal tube. This maneuver may, however, be hazardous in children between 5 and 10 years of age with loose deciduous teeth.

When should you not consider the use of an oropharyngeal airway?

Using an oropharyngeal airway on a conscious patient with an intact gag reflex is contraindicated. Patients that can cough still have a gag reflex and an OPA should not be used. If the patient has a foreign body obstructing the airway, an OPA should also not be used.

What is the typical size of a nasopharyngeal airway in adults?

When placing an NPA, the healthcare provider should be knowledgeable regarding the sizing of the NPA. Adult sizes range from 6 to 9 cm. Sizes 6 to 7 cm should be considered in the small adult, 7 to 8 cm in the medium size adult, and 8 to 9 cm in the large adult.

What special considerations are there for placing an OPA in a pediatric patient?

General paediatric airway considerations: It is important to have access to a full range of OPA sizes, to ensure the equipment is appropriately sized to the patient. Remove any visible debris and suction vomitus/secretions if necessary, as this keeps the airway clear.

How do you use an oropharyngeal airway?

The correct size OPA is chosen by measuring from the first incisors to the angle of the jaw. The airway is then inserted into the person’s mouth upside down. Once contact is made with the back of the throat, the airway is rotated 180 degrees, allowing for easy insertion, and assuring that the tongue is secured.

When should you not consider the use of an oropharyngeal airway Opa?

How safe are oropharyngeal airways?

Because of the position against the base of the tongue and posterior pharyngeal wall, OPAs are poorly tolerated in the awake or inadequately anesthetized patient. Complications can occur with the use of OPAs, such as iatrogenic trauma and airway hyperreactivity.

What patient is an appropriate candidate for placement of an oropharyngeal airway OPA?

The oropharyngeal airway (OPA) is a J-shaped device that fits over the tongue to hold the soft hypopharyngeal structures and the tongue away from the posterior wall of the pharynx. OPA is used in persons who are at risk for developing airway obstruction from the tongue or from relaxed upper airway muscle.

How do we measure oropharyngeal airway sizes?

Two external facial measurements have been recommended as reference criteria for estimating appropriate oropharyngeal airway sizes: the distances between the maxillary incisors to the angle of the mandible, and that from the corner of the mouth to the angle of the mandible.

Is there ventilation through the oropharyngeal airway in oral mucosa?

Results: In the maxillary incisors to the angle of the mandible group, there was clear manual ventilation through the oropharyngeal airway in all patients, whereas partially obstructed ventilation was observed in 6% of patients in the corner of the mouth to the angle of the mandible group.

How many patients have complete obstruction of the airway by the tongue?

In the maxillary incisors to the angle of the mandible group, the endoscopy did not identify any patient with complete obstruction of the airway by the tongue but in the corner of the mouth to the angle of the mandible group, 40% of patients had complete obstruction by the tongue.

How is the view at the distal end of the airway evaluated?

Before changing the oropharyngeal airway, the view at the distal end of each airway was evaluated using endoscopy via a fibreoptic bronchoscope. Main outcome measures: Ventilation parameters and the endoscopic views at the distal ends of the airways were assessed.