Lesson 7

Oro- or Nasopharyngeal Airway

  • Used to relieve upper airway obstruction by displacing tongue and epiglottis.

Sizing an Airway

  • OPA: Measure from the corner of the mouth to the earlobe or angle of the mandible.
  • NPA: Measure from the nare to the earlobe or angle of the mandible.

Advantages of Each Airway Type

Oropharyngeal Airways (OPA)

  • Types: Guedel, Berman, Williams, Ovassapian.
    • Guedel: Blind orotracheal intubation.
    • Berman: Fiberoptic intubation.
    • Williams/Ovassapian: Accommodate fiberoptic bronchoscope & endotracheal tube.

Complications of Airway Placement

  • Laryngospasm, vomiting, dental injury, oropharyngeal trauma, ischemia.
  • Tolerability: NPA usually better tolerated in lightly anesthetized patients.

Nasopharyngeal Airway Contraindications

  • Avoid in:
    • Cribriform plate injury (e.g., LeFort 2 or 3 fracture).
    • Coagulopathy (risk of epistaxis).
    • Previous nasal surgeries, fractures.

Cribriform Plate

  • Separates nasal cavity from anterior cranial fossa.
  • Injury risk includes entry of NPA into brain.