Emergency Medicine Book

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Oropharyngeal AirwayAka: Oral Airway

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  1. Indications
    1. Airway maintenance in the unconscious patient
    2. Protects an Endotracheal Tube from being bitten
    3. Facilitates Airway Suctioning
  2. Sizing
    1. General Sizing
      1. Flange at corner of mouth
      2. Tip at jaw angle
    2. Adult
      1. Large: 100 mm flange to tip (Guedel 5)
      2. Medium: 90 mm flange to tip (Guedel 4)
      3. Small: 80 mm flange to tip (Guedel 3)
    3. Child
      1. Lengths: 40-80 mm (Guedel sizes 000 to 3)
  3. Technique
    1. Suction airway of secretions, blood, vomit
    2. Method 1 (Children)
      1. Tongue depressor holds down Tongue for insertion
    3. Method 2 (Only use in adults)
      1. If used in child, then risk of Soft Palate injury
      2. Oral airway is inverted for insertion
      3. Rotated 180 degrees as the oral airway approaches
        1. posterior oropharynx
  4. Complications
    1. Oral airway too long
      1. Obstructs larynx by forcing down epiglottis
    2. Oral airway too short
      1. Tongue obstruction of airway
    3. Vomiting and laryngospasm in the awake patient

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