- To rapidly assist in maintaining the airway patency of an unconscious patient with at risk airway.
The placement of an OPA MUST NOT interrupt effective compressions in Cardiac Arrest.
- If the patient gags during the insertion of the oropharyngeal airway, remove immediately and be prepared to suction.
- Paediatrics <6 years: insertion should be performed without twisting and should follow the natural curvature of the airway to prevent damage to the oropharynx.
- Suspicion of traumatic injury: ensure spinal alignment and immobilisation of head and neck (jaw thrust method).
- Jaw thrust, double or triple airway manoeuvre is still required for effective spontaneous or positive pressure ventilation.
- Incorrect use of OPA may cause further airway obstruction.
- Incorrect use in patients suffering from a traumatic brain injury may have increased intracranial pressure and secondary brain injury.
- All relevant infection control methods to be utilised.
- Select the most appropriate OPA size by measuring from the centre of the lips to the angle of the mandible [1].
- Place patient’s head in a neutral position.
- Ensure airway is clear; suction if necessary.
- Open the patient’s mouth using the cross finger method.
- Orientate the OPA tip to the roof of the mouth, insert it approx. 1/3 of its length, then rotate it slowly to allow the tip to point downwards while gently pushing it into the airway[2][3].
- Progress the OPA gently into the mouth until the flange is resting on the lips[4].
- Ensure the tongue has not been inadvertently displaced into the back of the throat.
- Assess efficacy of inserted OPA by observing chest rise and fall.
- If OPA is unable to be inserted due to trismus, consider insertion of nasopharyngeal airway (NPA).
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