What are some basic things to know before using an oropharyngeal airway

An oropharyngeal airway is a rigid, flattened, tube-shaped artificial airway made of elastic rubber or plastic. It is curved to conform to the shape of the tongue and soft palate, making insertion easy. The oropharyngeal airway commonly used in clinical practice is an oval-shaped, hollow plastic tube with an S-shape. It is easy to use and requires no special instruments, allowing for rapid opening of the patient's airway within seconds. Therefore, it has been widely used in clinical settings and pre-hospital emergency care in recent years.

I. Indications
1. Patients with respiratory tract obstruction.
2. To facilitate suctioning when there is excessive secretion in the mouth, pharynx, and larynx.
3. To protect the tongue and teeth from injury during epileptic seizures or convulsions.
4. To act as a bite block when a tracheal tube is in place, preventing the tracheal tube from being bitten.

II. Contraindications
1. Laryngeal edema, foreign body in the trachea, asthma, hyperactive pharyngeal reflex;
2. Patients with a risk of fracture or dislodgement of the four front teeth in the oral cavity: generally contraindicated. If insertion is necessary, the patient should be placed in a lateral position to prevent teeth from falling into the pharynx and being aspirated into the trachea, causing suffocation;
3. If the patient experiences frequent and copious vomiting, increasing the risk of aspiration, endotracheal intubation or tracheostomy should be performed promptly.
4. A small number of patients using oropharyngeal airways may experience aspiration of gastric contents. Therefore, for patients who have recently eaten a meal, undergone manual gastric lavage, or suffered a head injury, it is recommended to place a nasogastric tube in addition to strengthening suction to prevent aspiration.
5. Oropharyngeal airways can cause elevated blood pressure and increased heart rate; therefore, they should not be used for extended periods in patients with hypertension or arrhythmias.

Airway management techniques: Maintain an open airway. The patient should be lying flat with their shoulders elevated. The tongue should be moved forward, lifting the base of the tongue and increasing the space between the base of the tongue and the pharyngeal wall.

1. The oropharyngeal airway is a rigid, flattened, tube-shaped artificial airway made of elastic rubber or plastic, and is curved to resemble the shape of the tongue and soft palate. Currently, there are four systems and two types available:
- Soft oropharyngeal airway (sizes: 55–115 mm).
- Mouth-to-mouth resuscitation oropharyngeal airway (sizes: adult 80–105 mm).
- Semi-rigid oropharyngeal airway (sizes: 40–110 mm).
- Dual-channel semi-rigid oropharyngeal airway (sizes: 40–100 mm).

Rubber type: Black and soft, with a central lumen, offering two functions: facilitating sputum suction and improving ventilation.
Plastic type: White and semi-rigid, without a central lumen, but with small lumens on both sides, primarily for improving ventilation.

2. Method for measuring the length: -The length of the oropharyngeal airway should be equivalent to the distance from the incisors to the earlobe or the angle of the mandible. -The oropharyngeal airway should be wide enough to contact 2-3 teeth of both the upper and lower jaw for optimal fit. 3. Precautions: -Selection principle: Choose a tube that is too large rather than too small, and too long rather than too short. A tube that is too small can easily enter the trachea, and one that is too short will not reach past the tongue and will not effectively open the airway. -Select the appropriate size based on the patient's age, height, and body type: The length of the oropharyngeal airway should be equal to the distance from the incisors to the angle of the mandible, so that its distal end is located in the hypopharynx, above the free edge of the epiglottis, with the flanges on the outside of the upper and lower incisors, separating the base of the tongue from the posterior pharyngeal wall, thus ensuring a clear airway from the hypopharynx to the glottis.

3. Precautions:
-Selection principle: Choose a tube that is too large rather than too small, and too long rather than too short. A tube that is too small can easily enter the trachea, and one that is too short will not reach past the tongue and will not effectively open the airway.
-Select the appropriate size based on the patient's age, height, and body type: The length of the oropharyngeal airway should be equal to the distance from the incisors to the angle of the mandible, so that its distal end is located in the hypopharynx, above the free edge of the epiglottis, with the flanges on the outside of the upper and lower incisors, separating the base of the tongue from the posterior pharyngeal wall, thus ensuring a clear airway from the hypopharynx to the glottis.