Videos

Oropharyngeal airway animated demonstration

How to size and insert an oropharygeal airway.

Equipment needed

  • Personal protective equipment, including gloves

  • Bag-valve-mask apparatus

  • Oxygen

  • Reservoir bag attached to the bag-valve-mask apparatus

  • Suction

  • Oropharyngeal airway

  • Nasopharyngeal airway (have available to use if needed)

  • Resuscitation kit.

Contraindications

Airway adjuncts have limited contraindications, but oropharyngeal airways are contraindicated in a patient who is conscious, as they are likely to induce vomiting and laryngospasm. They should also not be used in patients with oral airway obstruction secondary to a foreign body, as the oropharyngeal airway is likely to push it further into the larynx.

Complete upper airway obstruction is an absolute contraindication for bag-valve-mask ventilation.

Indications

  • Respiratory failure

  • Failed intubation.

An oropharyngeal airway, otherwise called a Guedel airway, can be used to help maintain airway patency in a resuscitation situation. An oropharyngeal tube helps keep the airway open by preventing the soft tissues from occluding the airway above the laryngeal opening. Once in place, it is most effective in combination with the head-tilt and chin-lift manoeuvres.

Complications

  • Vomiting

  • Aspiration.

Aftercare

After inserting an oropharyngeal airway it may be necessary to suction material from the oropharynx.

Look, listen, and feel to check for patency of the airway and adequate ventilation. Simple airway manoeuvres may still be required.

The patent oropharyngeal airway should enable oxygenation and ventilation of the lungs with either pocket mask ventilation or bag-mask-valve ventilation.

Continue to resuscitate the patient in keeping with life support guidelines, using ABCDE principles.

If the patient continues to require resuscitation, airway and mask ventilation should be replaced by a definitive airway and ventilation. An advanced airway enables chest compressions to be delivered continuously without pausing during ventilation. Most patients with return of spontaneous circulation remain comatose and will need tracheal intubation and mechanical ventilation.[187]​​