Airway management is an important aspect of medical care, ensuring that a clear path for breathing remains open. This process is essential for delivering oxygen and removing carbon dioxide. When a person’s natural ability to maintain this pathway is compromised, various tools and techniques become necessary. Among these, the oropharyngeal airway is a commonly used device designed to assist in keeping the breathing passage unobstructed.
What It Is
An oropharyngeal airway, often referred to as an OPA or oral airway, is a medical device designed to maintain an open air passage. It is typically a curved, rigid, J-shaped tube made from plastic or rubber materials. It features distinct parts: a flange that rests outside the mouth, a curved body that follows the natural shape of the mouth and throat, a tip that extends into the pharynx, and a channel to allow for air and suction. OPAs are available in a wide range of sizes, from approximately 40 mm to 110 mm, to accommodate different patient anatomies (infants, children, and adults). The curved design allows it to conform to the tongue and displace it from the posterior pharyngeal wall.
Why It Is Used
The main purpose of an oropharyngeal airway is to prevent the tongue from obstructing the upper airway, a common problem in individuals who are unconscious or deeply sedated. When a person loses consciousness, the muscles in their jaw and tongue relax, causing the tongue to fall backward and block the epiglottis, preventing breathing. This obstruction can occur in various scenarios, such as during general anesthesia, deep sedation for medical procedures, or in emergency situations where a patient’s protective reflexes are diminished. The OPA also facilitates bag-valve-mask ventilation, making it more effective by ensuring an open pathway for oxygen.
How It Works
The oropharyngeal airway functions by mechanically lifting and displacing the tongue from the posterior wall of the pharynx, establishing a clear air passage. Its J-shaped curve is engineered to fit over the tongue, holding it forward and preventing it from collapsing backward into the throat. This action ensures the epiglottis, a flap of cartilage covering the windpipe during swallowing, remains open for breathing. By maintaining this open pathway, the oropharyngeal airway effectively bypasses the most common cause of upper airway obstruction in unconscious patients.
Key Principles of Application
Effective and safe use of an oropharyngeal airway requires adherence to specific principles and should only be performed by trained medical professionals. Proper sizing is important; an OPA that is too small may not effectively move the tongue, while one that is too large can cause trauma or worsen the obstruction. The correct size is typically determined by measuring the device from the corner of the patient’s mouth to the angle of their jaw. It is important that the oropharyngeal airway is used only in unconscious or deeply sedated patients who lack a gag reflex. Insertion into a conscious patient or one with an intact gag reflex can trigger vomiting, risking aspiration (stomach contents entering the lungs).