The Importance Of Proper Care And Insertion of Airways
Whether it’s an oropharyngeal airway or a nasopharyngeal airway, ensuring your knowledge base to know when to employ these adjuncts and the correct procedure for insertion can significantly affect patient outcomes.
Oropharyngeal Airway Care
The oropharyngeal airway adjunct is a curved plastic tube that medical professionals insert into the patient’s mouth to prevent the tongue from obstructing the airway. This tool comes in various sizes to fit different patient populations.
Proper Oropharyngeal Airway Insertion
Measure from the corner of the patient’s mouth to the angle of the jaw. The correct size OPA should be approximately the same length as this measurement. You can use the length of the patient’s middle finger as a rough estimate for the size of the OPA.
The tip of the OPA should not extend beyond the patient’s lips. When unsure about the correct size, start with a slightly smaller OPA and gradually increase the size if needed.
Infants and children may require smaller OPAs than adults. Use age-appropriate sizing guidelines when determining the size of the OPA.
After choosing the correct size of OPA, ensure the OPA is clean and lubricated with water-soluble lubricant.
Position the patient on their back with their head in a neutral position. Open the patient’s mouth using a cross-finger technique (place your thumb on the lower teeth and your index finger on the upper teeth). Insert the OPA into the patient’s mouth with the tip facing downward, following the natural curve of the tongue. Continue gently advancing the OPA until the flange rests against the patient’s lips.
Check for proper placement by looking for the tip of the OPA at the back of the throat and ensuring the flange rests against the patient’s lips. Secure the OPA by taping it to the patient’s face or using a commercially available securing device. Monitor the patient for discomfort or obstruction and adjust the OPA as needed.
If the patient regains consciousness or begins to cough, remove the OPA immediately to prevent injury.
Document the insertion of the OPA in the patient’s medical records, including the size used and any observations made during the procedure.
Nasopharyngeal Airway Care
Nasopharyngeal airways are inserted through the nose and into the back of the throat, bypassing the mouth.
Reasons to choose an NPA over an OPA
The patient has an obstruction blocking the oropharyngeal route.
If an obstruction blocks the oropharyngeal route, use the nasopharyngeal airways.
The patient has a strong gag reflex.
Some patients may find an NPA more comfortable than an OPA because an NPA runs through the nasal passage rather than the mouth. This means it causes less stimulation of the gag reflex. Using an NPA can reduce the risk of aspiration in patients with a higher risk of vomiting or regurgitation.
The patient has oral trauma or facial fractures.
In cases where the patient has suspected oral trauma or facial fractures, using an NPA may be preferable to avoid exacerbating the injuries.
NPAs can improve patient comfort, decrease the risk of aspiration, and be used more extended periods than OPAs without causing discomfort or complications, making them suitable for extended airway management.
Proper Nasopharyngeal Airway Insertion
Determine the correct NPA size. Measure from the tip of the patient’s nose to the earlobe or the corner of the mouth to estimate the appropriate NPA size. Choose a smaller size for pediatric or geriatric patients. Whenever you’re unsure, use a smaller NPA.
Lubricate the NPA with water-soluble lubricant to ease insertion. Lay the patient on their back with their head in a neutral position. Gently insert the NPA tip into one nostril with a slight twisting motion, directing it towards the back of the throat. Advance the NPA along the floor of the nasal passage until the flange rests against the patient’s nostril.
Check for proper placement by observing adequate airflow through the NPA and listening for breath sounds. Secure the NPA by gently taping it to the patient’s face.
Follow proper sizing and insertion techniques when using an NPA to ensure optimal airway management and ventilation in patients requiring breathing assistance.
Proper use of oropharyngeal and nasopharyngeal airways can optimize patient outcomes and prevent potential complications. Familiarize yourself with the appropriate tools and insertion techniques to provide the best care for patients requiring airway support.
