Which patient is appropriate to use an oropharyngeal airway?
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Several manoeuvres and devices can be used to restore patency in patients with a threatened airway. This page outlines the basic interventions that can be provided in these patients. Before using any airway
manoeuvres or adjuncts, first assess whether the airway is patent. If the patient is talking then this suggests that their airway is patent (however, this is not always the case). Look, listen and feel for movement of air. Stridor and snoring are both signs of airway compromise. Airway ManoeuvresAirway manoeuvres are used to relieve upper airway obstruction, and maintain a patent airway.
Airway AdjunctsAirway adjuncts are used to relieve upper airway obstruction.
Measure the airway from the angle of the mandible to the maxillary incisors. First, use suction to ensure that the mouth is clear of secretions. Angle the airway superiorly, toward the palate, and then insert it into the oral cavity. Once the airway reaches the oropharynx, rotate it 180 degrees toward the larynx. Oropharyngeal airways are contraindicated in conscious patients, and patients who can cough or have an active gag reflex - these patients will not tolerate the airway.
Measure the airway from the tip of the earlobe to the nostril. Point the airway toward the midline, and then insert it backward into the nasal cavity until the flange reaches the nostril. Lubricant may be used to facilitate insertion of a nasopharyngeal airway. Nasopharyngeal airways are contraindicated in patients with suspected nasal / base of skull fracture, and patients who are actively bleeding from the nose. Advanced Airway Interventions
A bag-valve-mask system may be used with an oropharyngeal or nasopharyngeal airway in situ, to aid in opening the airway.
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