Oropharyngeal Airway
OVERVIEW
- Oropharyngeal airway (OPA) aka Guedel airway
USE
- Lifts the tongue off the posterior pharyngeal wall to prevent airway obstruction
- bite block
- assist oropharyngeal suctioning
- promotes moulding of the face of a mask for manual ventilation
DESCRIPTION
- Sizes: equal to length in cm
- colour coded bite portions can aid easy size identification (children – 00, 1, 2; adults – 4, 5, 6)
- sized by measuring from the center of the mouth between the first incisors to the angle of the mandible in an adult
Parts:
- flange to prevent overinsertion
- reinforced bite section
- curved body to conform over tongue/palate
- tubular air channel
METHOD OF INSERTION/ USE
- Children – insert directly over the tongue ideally with aid of a tongue depressor (no twisting through 180 degrees)
- Adults – rotate 180 degrees from concave upwards position as it is inserted over the tongue
- Lubricant may aid insertion
COMPLICATIONS
- gagging, vomiting and aspiration
- soft tissue trauma to the tongue, palate and pharynx
- biting down on the hard surface can injure the teeth
OTHER INFORMATION
- Berman airway – is similar but has a grove in the size; may be used to facilitate passage of a bronchoscope – once it is inserted into the larynx the device can be slid off the side of the scope and an endotracheal tube fed into the larynx
- COPA (Cuffed Oropharyngeal Airway) is a variant with an inflatable cuff to seal the oropharynx and has a universal connector attached to the bite block to allow ventilation – limited popularity and scope.
References and Links
- Arthur Ernest Guedel (1883-1956) – The Guedel airway
- Robert Alvin Berman (1914-1999) – The Berman airway
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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