Reasonable Rascal
02-13-03, 22:34
Oralpharyngeal airways, or more commonly called simply oral airways for brevity, are a skill within reach of any literate person. They require nothing more than a plastic airway and attention to detail. When properly applied they may be truly lifesaving.
They are available as sets of various sizes so that they may be matched to the size of the patient, ranging from neonates to large, tall adults. Most adult males will use a 100 or 110 mm length airway, most adult females a 90 - 100 mm length airway. I made a practice of carrying a 110 mm airway on my belt kit and adjusted from there is it was too large. Partial insertion would hold the tongue back long enough to dig into the bag for the proper sized unit for somewhat smaller adults by leaving it twisted sideways to hold the tongue without obscuring the back of the throat.
RR
The following is public-use info obtained from the Combat Lifesaver Course: Medical Tasks book
DETERMINE IF THE OROPHARYNGEAL AIRWAY IS THE APPROPRIATE SIZE
Place the oropharyngeal airway along the outside of the casualty's jaw with one end of the airway at the bottom tip of the casualty's ear. Close the casualty's mouth (jaw in normal position) and bring the other tip of the airway toward the corner of the casualty's mouth. The airway should reach from the bottom tip of his ear to the corner of his mouth. If the airway is too short, it might not be able to hold the casualty's tongue in place. If the airway is too long, it might injure the casualty's throat. Also, the oropharyngeal airway might completely block the casualty's airway if is not the correct size. Choose the airway that is nearest to the proper size (tip of ear lobe to corner of mouth).
INSERT THE OROPHARYNGEAL AIRWAY
Position the casualty on his back (may already in this position).
Place your thumb and your index finger of one hand on the casualty's upper and lower teeth near a corner of his mouth so they will cross when the casualty's mouth is opened (crossed-finger method).
Push your thumb and your index finger against the casualty's upper and lower teeth in a scissors-like motion until his mouth opens.
WARNING:Do not place your fingers inside the casualty's mouth.
Once the casualty's mouth is open, maintain his airway. This is normally accomplished using the head-tilt/chin-lift method. Use the jaw-thrust method if the casualty has a possible fracture of the neck or spine or if the casualty has a severe head injury.
Place the tip end (not the flanged end) of the oropharyngeal airway into the casualty's mouth. Make sure the tube is on top of the tongue. Position the airway with the tip pointing up toward the roof of the casualty's mouth. This will help to keep the tongue from being pushed toward the back of the throat as the airway is inserted.
Slide the airway along the roof of the casualty's mouth, following the natural curvature of the tongue.
INSERTING THE OROPHARYNGEAL AIRWAY
When the tip of the airway reaches the back of the tongue (past the soft palate), rotate the airway 180 degrees so the tip end of the airway is pointing down toward his throat. If the airway is difficult to insert or rotate, grasp the casualty's tongue with the fingertips of the hand not holding the airway and gently pull the tongue forward.
Advance the airway until the flange rests against the casualty's lips. The airway should now be positioned so the tongue is held in place and does not slide to the back of the casualty's throat.
MONITOR A CASUALTY WITH AN OROPHARYNGEAL AIRWAY IN PLACE
Check the casualty's respirations to make sure he is still breathing adequately and the oropharyngeal airway is not blocking his airway. Adjust the position of the oropharyngeal airway, if needed. If the oropharyngeal airway completely blocks the casualty's airway, remove the artificial airway and keep the casualty's airway open using the jaw thrust or the head-tilt/chin-lift.
Remove the oropharyngeal airway if the casualty begins to gag or regain consciousness. If the airway is not removed, the casualty may vomit.
NOTE: The casualty may push the oropharyngeal airway out of his mouth as he regains consciousness.
Do not tie or tape the airway in place.
They are available as sets of various sizes so that they may be matched to the size of the patient, ranging from neonates to large, tall adults. Most adult males will use a 100 or 110 mm length airway, most adult females a 90 - 100 mm length airway. I made a practice of carrying a 110 mm airway on my belt kit and adjusted from there is it was too large. Partial insertion would hold the tongue back long enough to dig into the bag for the proper sized unit for somewhat smaller adults by leaving it twisted sideways to hold the tongue without obscuring the back of the throat.
RR
The following is public-use info obtained from the Combat Lifesaver Course: Medical Tasks book
DETERMINE IF THE OROPHARYNGEAL AIRWAY IS THE APPROPRIATE SIZE
Place the oropharyngeal airway along the outside of the casualty's jaw with one end of the airway at the bottom tip of the casualty's ear. Close the casualty's mouth (jaw in normal position) and bring the other tip of the airway toward the corner of the casualty's mouth. The airway should reach from the bottom tip of his ear to the corner of his mouth. If the airway is too short, it might not be able to hold the casualty's tongue in place. If the airway is too long, it might injure the casualty's throat. Also, the oropharyngeal airway might completely block the casualty's airway if is not the correct size. Choose the airway that is nearest to the proper size (tip of ear lobe to corner of mouth).
INSERT THE OROPHARYNGEAL AIRWAY
Position the casualty on his back (may already in this position).
Place your thumb and your index finger of one hand on the casualty's upper and lower teeth near a corner of his mouth so they will cross when the casualty's mouth is opened (crossed-finger method).
Push your thumb and your index finger against the casualty's upper and lower teeth in a scissors-like motion until his mouth opens.
WARNING:Do not place your fingers inside the casualty's mouth.
Once the casualty's mouth is open, maintain his airway. This is normally accomplished using the head-tilt/chin-lift method. Use the jaw-thrust method if the casualty has a possible fracture of the neck or spine or if the casualty has a severe head injury.
Place the tip end (not the flanged end) of the oropharyngeal airway into the casualty's mouth. Make sure the tube is on top of the tongue. Position the airway with the tip pointing up toward the roof of the casualty's mouth. This will help to keep the tongue from being pushed toward the back of the throat as the airway is inserted.
Slide the airway along the roof of the casualty's mouth, following the natural curvature of the tongue.
INSERTING THE OROPHARYNGEAL AIRWAY
When the tip of the airway reaches the back of the tongue (past the soft palate), rotate the airway 180 degrees so the tip end of the airway is pointing down toward his throat. If the airway is difficult to insert or rotate, grasp the casualty's tongue with the fingertips of the hand not holding the airway and gently pull the tongue forward.
Advance the airway until the flange rests against the casualty's lips. The airway should now be positioned so the tongue is held in place and does not slide to the back of the casualty's throat.
MONITOR A CASUALTY WITH AN OROPHARYNGEAL AIRWAY IN PLACE
Check the casualty's respirations to make sure he is still breathing adequately and the oropharyngeal airway is not blocking his airway. Adjust the position of the oropharyngeal airway, if needed. If the oropharyngeal airway completely blocks the casualty's airway, remove the artificial airway and keep the casualty's airway open using the jaw thrust or the head-tilt/chin-lift.
Remove the oropharyngeal airway if the casualty begins to gag or regain consciousness. If the airway is not removed, the casualty may vomit.
NOTE: The casualty may push the oropharyngeal airway out of his mouth as he regains consciousness.
Do not tie or tape the airway in place.