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AIRWAY MANAGEMENT

If bag-mask ventilation is adequate, providers may defer insertion of an advanced airway. Health care providers should make the decision as to the appropriateness of placing an advanced airway during the ACLS Survey. The value of securing the airway must be balanced against the need to minimize the interruption in perfusion that results in halting CPR during airway placement.

Basic airway equipment includes the oropharyngeal airway (OPA) and the nasopharyngeal airway (NPA). The primary difference between an OPA (Fig. 1) and a NPA (Fig. 2) is that an OPA is placed in the mouth (Fig. 3), while a NPA is inserted through the nose (Fig. 4). Both terminate in the pharynx. The main advantage of an NPA over an OPA is that it can be used in either conscious or unconscious patients because the device does not stimulate the gag reflex.

Advanced airway equipment includes the laryngeal mask airway (LMA), laryngeal tube, esophageal-tracheal tube, and endotracheal tube. Different styles of these supraglottic airways are available. If it is within your scope of practice, you may use advanced airway equipment when appropriate and available.

various sizes of oropharyngeal airways
Fig 1.

various sizes of nasopharyngeal airways
Fig 2.

example placement of oropharyngeal airway
Fig 3.

example placement of nasopharyngeal airway
Fig 4.