How To Insert an Oropharyngeal Airway? (1)

The oropharyngeal airway is a rigid intraoral device that fits over the tongue and displaces it from the posterior pharyngeal wall, thereby restoring pharyngeal airway patency.

Pharyngeal airways (oropharyngeal and nasopharyngeal) are part of the initial upper airway management of patients with apnea or severe ventilatory failure, which also includes proper patient positioning, manual jaw manipulation

All of these approaches have the goal of relieving upper airway obstruction caused by a relaxed tongue resting on the posterior pharyngeal wall.

Oropharyngeal airway indications
Oropharyngeal airway is suitable for comatose patients

• Bag-mask ventilation
• Spontaneously breathing patients, upper airway soft tissue obstruction, slow breathing depth, no gag reflex

Contraindications for oropharyngeal airway
Absolute contraindications

• Consciousness or presence of gag reflex

Relative contraindications
In some cases, insertion of an oropharyngeal airway may not be feasible,A nasopharyngeal airway may be used instead. such as

• Oral trauma
• Occlusal difficulties (limited mouth opening, including masticatory muscle spasm

Oropharyngeal airway complications

• Airway obstruction due to inadequate or improperly inserted oropharyngeal airway
• Potential for vomiting and vomit aspiration

Oropharyngeal airway equipment

• Gloves, masks, and gowns
• Towels, sheets, or commercial equipment (as needed to place the neck and head in the sniffing position)
• Oropharyngeal airways of various sizes
• Suction devices and Yankauer catheters; Magill forceps (if needed to remove easily accessible foreign bodies), pharyngeal cleansing as needed
• Nasogastric tube, as needed to relieve gastric distension

Other considerations for oropharyngeal airways
The use of an oropharyngeal airway in conjunction with a nasopharyngeal airway may improve oxygenation and ventilation.

Relevant anatomy of the oropharyngeal airway

• Aligning the external auditory canal with the sternal notch may help open the upper airway and establish an optimal position for viewing the airway if endotracheal intubation is required.
• The degree of head elevation that optimally aligns the ear and sternal notch varies (eg, no elevation in children with large occipital bones, greater elevation in obese patients).