An oropharyngeal airway (OPA) is a medical device that maintains an open airway in unconscious or unresponsive individuals. It prevents the tongue from falling back and obstructing the upper airway, a common issue in patients with diminished consciousness. The OPA serves as a temporary measure to facilitate breathing until more advanced airway management can be implemented or the person’s condition improves.
Understanding the Oropharyngeal Airway
An oropharyngeal airway is constructed from rigid plastic. These devices have a curved, hollow design that mirrors the natural curvature of the oral cavity and pharynx. They are available in a range of sizes, from small infant sizes (approximately 40 millimeters) to larger adult sizes (up to 110 millimeters).
The OPA creates a clear passage for air by lifting the tongue away from the posterior wall of the pharynx. When a person is unconscious, the muscles supporting the tongue can relax, causing it to fall backward and block the airway. The OPA’s design allows it to sit over the tongue, extending from the lips or teeth to the back of the throat, physically preventing this obstruction.
Key Situations for OPA Use
Oropharyngeal airways are used in medical emergencies and clinical settings when a person’s consciousness is impaired. Individuals experiencing an overdose of certain medications or illicit substances may have a reduced level of consciousness that necessitates OPA placement.
During the recovery phase after a seizure, a person may remain unconscious or semi-conscious. Patients with severe head injuries can also have compromised consciousness, requiring an OPA to maintain an open airway until their neurological status improves or definitive airway management is established. General anesthesia is another scenario where an OPA is used, as it temporarily paralyzes the muscles that control the airway, necessitating mechanical support to ensure ventilation.
The OPA provides immediate relief from airway obstruction while medical professionals assess the situation and prepare for more advanced interventions if needed. Its application is a swift and effective method to restore airflow and prevent hypoxia in emergency situations. The device helps ensure oxygen delivery to the brain and other vital organs, which is important during periods of unconsciousness.
Proper Use and Placement
The insertion of an oropharyngeal airway requires careful technique to ensure effectiveness and avoid injury. One common method involves inserting the OPA upside down, with the tip pointing towards the roof of the mouth, then rotating it 180 degrees as it reaches the soft palate. This rotation helps guide the device around the tongue and into its correct position without pushing the tongue backward.
Alternatively, a tongue depressor can be used to hold the tongue down while the OPA is inserted straight in. Selecting the correct size OPA is important. An appropriately sized OPA extends from the corner of the mouth to the angle of the jaw, ensuring it adequately clears the tongue without extending too far and stimulating the gag reflex or causing tracheal compression.
Once correctly placed, the OPA should sit securely in the mouth, maintaining a clear passage for air. Medical professionals continuously monitor the patient’s breathing and level of consciousness to confirm the OPA’s effectiveness and to determine when it can be safely removed. Proper positioning and ongoing assessment are important for optimal airway management.
Safety and Important Warnings
The use of an oropharyngeal airway requires specialized training and should only be performed by qualified medical professionals, such as paramedics, nurses, and physicians. Improper insertion or use can lead to complications, including trauma to the oral cavity, palate, or pharynx. For instance, forcing an ill-sized OPA can cause lacerations or bleeding.
A contraindication for OPA use is the presence of an intact gag reflex. If a conscious or semi-conscious patient still has a gag reflex, inserting an OPA can trigger vomiting, which carries a high risk of aspiration. Aspiration occurs when stomach contents enter the lungs, potentially leading to severe respiratory complications like pneumonia. Before insertion, medical personnel must assess the patient’s level of consciousness and check for a gag reflex.
The OPA is not a definitive airway solution but rather a temporary adjunct. It does not protect the airway from aspiration of gastric contents or blood, nor does it prevent laryngospasm. Continuous monitoring of the patient’s airway and overall condition is important while an OPA is in place, as their status can change rapidly.