Airway Adjunct - Oropharyngeal & Nasopharyngeal Airway

Thursday, 19 February 2009 18:20 Equipment

When a person becomes unconscious, the muscles in their jaw relax and may allow the tongue to obstruct the airway; in fact, the tongue is the most common cause of a blocked airway. 

An oropharyngeal airway (OPA) is a curved piece of plastic medical device called an airway adjunct used to maintain a patent (open) airway. It does this by preventing the tongue from (either partially or completely) covering the epiglottis, which could prevent the patient from breathing.

Designed by Arthur E. Guedel, OPA has various sizes. The correct size OPA is chosen by measuring against the patient's head (from the earlobe to the corner of the mouth).


The airway is then inserted into the patient's mouth upside down. Once contact is made with the back of the throat, the airway is rotated 180 degrees, allowing for easy insertion, and assuring that the tongue is secured. Measuring is very important, as the flared ends of the airway must rest securely against the oral opening in order to remain secure. An alternative method for insertion, the method that is recommended for OPA use in children and infants, involves holding the tongue forward with a tongue depressor and inserting the airway right side up.

To remove the device, it is pulled out following the curvature of the tongue; no rotation is necessary.

Contraindication: OPA should not be used on any patient that has active gag reflex.

Nasopharyngeal airway (NPA), a type of airway adjunct, is a tube that is designed to be inserted into the nasal passageway to secure an open airway. It may be used in situations where an artificial form of airway maintenance is necessary but it is impossible or unadvisory to use an oropharyngeal airway.

The correct size airway is chosen by measuring the device on the patient: the device should reach from the patient's nostril to the earlobe or the angle of the jaw. The outside of the tube is lubricated with a water-based lubricant so that it enters the nose more easily. The device is inserted until the flared end rests against the nostril.

Contraindications: It is not to be used in patients with severe head or facial injuries, or have evidence of a basal skull fracture due to the possibility of direct intrusion upon brain tissue.


CorResponder : Tan Teik Kean

Last Updated on Thursday, 26 February 2009 13:47