OROPHARYNGEAL AIRWAY (OPA) INSERTION

The oropharyngeal airway (OPA) is a curved plastic device inserted into the mouth to help maintain an open airway by preventing the tongue from obstructing the passage of air. It is a simple but effective adjunct for airway management.

INDICATIONS

• Unconscious patient
• Absence of a gag reflex

CONTRAINDICATIONS

• Conscious or semi-conscious patient
• Presence of a gag reflex (insertion may induce vomiting and aspiration)
• Facial trauma

SIZING THE OPA

Proper sizing of the OPA is essential for effective use. An incorrectly sized OPA can worsen airway obstruction.

• Measure the OPA from the corner of the patient’s mouth to the earlobe or the angle of the jaw. The OPA should be the same length as this measurement.

INSERTION TECHNIQUE

1. Preparation: Select the correctly sized OPA.

2. Opening the Mouth: Open the patient’s mouth using the crossed-finger technique (insert your thumb and index finger into the mouth and cross them to open the jaw).

3. Initial Insertion: Insert the OPA upside down (with the curve pointing towards the roof of the mouth) until you meet resistance at the back of the throat.

4. Rotation: Rotate the OPA 180 degrees as you advance it further into the oropharynx. The tip of the OPA should now be resting over the base of the tongue, preventing it from obstructing the airway.

CONFIRMATION OF PLACEMENT

• Observe for chest rise with ventilation.
• Listen for breath sounds.

COMPLICATIONS

• Gagging and vomiting (if inserted in a patient with a gag reflex)
• Trauma to the oral cavity
• Tongue displacement

IMPORTANT CONSIDERATIONS

• The OPA is a temporary airway adjunct and should be replaced with a more definitive airway (e.g., endotracheal tube) if prolonged airway management is required.
• If the patient regains consciousness or develops a gag reflex, the OPA should be removed immediately.