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BASIC AIRWAY TECHNIQUE

INSERTING AN OROPHARYNGEAL AIRWAY (OPA)

STEP 1 - 
Clear the mouth of blood or secretions with suction, if possible.
STEP 2 - 
Select an airway device that is the correct size for the patient. *
* Too large of an airway device can damage the throat.
* Too small of an airway device can press the tongue into the airway.
STEP 3 - 
Place the device at the side of the patient’s face. Choose the device that extends from the corner of the mouth to the earlobe.
STEP 4 - 
Insert the device into the mouth so the point is toward the roof of the mouth or parallel to the teeth. *
* DO NOT press the tongue back into the throat.
STEP 5 - 
Once the device is almost fully inserted, turn it until the tongue is cupped by the interior curve of the device.

INSERTING A NASOPHARYNGEAL AIRWAY (NPA)

STEP 1 - 
Select an airway device that is the correct size for the patient.
STEP 2 - 
Place the device at the side of the patient’s face. Choose the device that extends from the tip of the nose to the earlobe. Use the largest diameter device that will fit.
STEP 3 - 
Lubricate the airway with a water-soluble lubricant or anesthetic jelly.
STEP 4 - 
Insert the device into the nostril slowly, moving straight into the face (not towards the brain).
STEP 5 - 
It should feel snug; do not force the device. If it feels stuck, remove it and try the other nostril.

TIPS ON SUCTIONING

  • When suctioning the oropharynx, do not insert the catheter too deeply. Extend the catheter to the maximum safe depth and suction as you withdraw.
  • When suctioning an endotracheal tube, remember the tube is within the trachea and you may be suctioning near the bronchi/lung. Therefore, sterile technique should be used.
  • Each suction attempt should be for no longer than 10 seconds. Remember the patient will not get oxygen during suctioning.
  • Monitor vital signs during suctioning and stop suctioning immediately if the patient experiences hypoxemia (O2 sats < 94%), has a new arrhythmia, or becomes cyanotic.
  • OPAs too large or too small may obstruct the airway.
  • NPAs sized incorrectly may enter the esophagus.
  • Always check for spontaneous respirations after insertion of either device.