An oropharyngeal airway (also known as an oral airway, OPA or Guedel pattern airway) is a medical device called an airway adjunct used in airway management.

1. Oropharyngeal Airway
Krishnakumar D
AVMC&H

3. Introduction:
• The aim of airway is to prevent the tongue fall.
• It is a J shape divece.
• Most commonly used is Guedel airway.
• The tip, inserted between tongue and posterior pharyngeal wall
prevents tongue falling back on posterior pharyngeal wall, and thus
maintaining the patency of airway.
• Airways are available in many sizes.
• The appropriate length is the distance between tip of nose and tragus
plus 1 cm.
• Nasal airways are also available which are inserted through nostril.

4. Indications:
• An oropharyngeal airway (oral airway, OPA) is an airway adjunct used
to maintain or open the airway by stopping the tongue from covering
the epiglottis.
• In this position, the tongue may prevent an individual from breathing.
• This sometimes happens when a person becomes unconscious because
the muscles in the jaw relax causing the tongue to obstruct the airway.
• During bag-mask ventilation with OPA support we can provide proper
ventilations.
• Intubation patient to preventing biting ET tube.

5. Contraindications:
• Avoid using an oropharyngeal airway on a conscious patient with an
intact gag reflex.
• If the patient can cough, they still have a gag reflex, and an oral airway
is contraindicated.
• If the patient has a foreign body obstructing the airway, an
oropharyngeal airway should not be used.
• An oropharyngeal airway should not be used on patients who have
nasal fractures or an actively bleeding nose.

6. Gentle pressure behind the jaw lifts the mandible and maintains airway
patency. Some clients dentition allows the operator to place the lower
teeth over the upper and maintain this position with one hand.

7. Different colours & size available:

9. Preparation:
• An oropharyngeal airway has four parts: the flange, the body, the tip,
and a channel to allow for passage of air and suction.
• Oropharyngeal airways come in a wide range of sizes.
• Choosing an appropriate oropharyngeal size is determined on an
individual basis through the use of anatomical landmarks.
• When determining the appropriate oropharyngeal size for a patient,
one must assess where the oropharyngeal airway parts lie in relation to
the patient’s anatomical landmarks.

10. • The flange should be approximated, externally, to where it is abutting
the lips, and the tip should be able to reach the angle of the mandible.
• Insertion of an oropharyngeal airway is not complicated but must be
done with care to avoid further worsening of the airway obstruction, as
well as, injuries to the airway.

11. Technique:
• There are several techniques, and the following are a few examples:
• Technique 1: First, open the mouth. Then, using a tongue depressor, push
down on the tongue and, with the tippointed caudally, insert the
oropharyngeal airway directly into the mouth over the tongue.
• Technique 2: First, open the mouth. Then, with the tip pointed cephalad,
insert the oropharyngeal airway into the mouth and then rotate it 180
degrees as it is advanced to the back of oropharynx. This technique carries
the potential of injuring the hard and soft palates of the oral cavity.
• Technique 3: First, open the mouth. Then, with the tip pointed at a corner of
the mouth, insert the oropharyngeal airway into the mouth and then rotate it
90 degrees as it is advanced to the back of oropharynx.

12. Complications:
• Complications potentially caused by the use of oropharyngeal airways
are that it may induce vomiting which may lead to aspiration.
• Additionally, it may cause or worsen airway obstruction if an
inappropriately sized airway is used (i.e., too small).
• An inappropriately sized airway can also cause laryngospasm (i.e., too
big).
• Lastly, damage to the oral structures or dentition can also result from
oropharyngeal airway insertion.