Oropharyngeal Airway

Indication
Temporary ventilation of the unconscious pt while preparing to intubate
Preferred method
1. Select correct size
- extends from pts mouth to external auditory canal.
- 2-3 typical for adults
2. Use a tongue blade to depress the tongue (don't gag them).
3. Insert the airway posteriorly.
4. Remove the tongue blade
5. Ventilate with bag-valve-mask
Alternative
1. Insert the airway upside down.
2. Then rotate to slip into place
- not in children: rotation may damage the mouth/pharynx.
Note
This is not for the conscious pt --> risk of inducing gagging, vomiting, aspiration.

Nasopharyngeal Airway

Contraindication
If facial fractures; risk of brain injury through skull base.
Indication

Used when a pt would gag on an oropharyngeal airway
Technique
1. Lubricate well a correctly sized airway
- size 6-7.5 typical.
2. Check nasal passages for obstruction, eg polyps, #, haemorrhage)
- insert into less obstructed nostril
3. Insert tip into nostril, directing posteriorly & towards the ear.
4. Insert through the nostril into the hypopharynx with slight rotation
- flange should rest against nostril.
5. Ventilate with bag-valve-mask
Note
Preferred in the conscious pt
- better tolerated, less gagging.
If obstruction encountered try the other side.
If its tip is seen in the oropharynx, it is possible to pass an NG tube through it for a patient with midface fractures.