Healthcare and Medicine Reference
Place the fi ngers of both hands under the corresponding side of
Maintaining an airway opened by a head-tilt/chin-lift or jaw
the mandible, at the angle of the jaw.
Lift the mandible forwards, opening the airway (avoid moving
As an alternative method of opening an obstructed airway when
the patient's head).
airway manoeuvres have failed.
As a 'bite-block' to protect an endotracheal tube.
Patients must be unconscious to tolerate an OP airway. Inserting
Use of airway adjuncts can assist in obtaining or maintaining an
unobstructed, open airway.
an airway in a semi-conscious patient may stimulate the gag
refl ex causing them to vomit, leading to further airway compro-
mise and potential aspiration.
An oropharyngeal (OP) airway is designed to hold the tongue away
from the posterior pharynx; this allows passage of air both through
the device itself and around it (Figure 13.2).
An oropharyngeal airway consists of three parts: a fl ange, the
body and the tip (Figure 13.3).
The fl ange protrudes from the patient's mouth. Its shape prevents
the airway slipping further into the oropharynx.
The body is made from rigid plastic anatomically designed to fi t the
contour of the hard palate. It curves over the top of the patient's
The tip sits at the base of the tongue allowing air passage through
and around the airway.
A correctly sized airway will extend from the corner of the
patient's mouth to the angle of the mandible (Figure 13.4).
Improper sizing can cause bleeding of the airway and obstruction
of the glottis.
Step-by-step guide: oropharyngeal airway
Choose an appropriately sized airway (Figure 13.4).
Open the patient's mouth (if an assistant is available get them to
do a jaw thrust).
Insert the airway upside down, with the curvature towards the
tongue and the tip towards the hard palate (Figure 13.5a).
When the airway reaches the back of the tongue, rotate the device
180° so the tip faces downwards (Figure 13.5b).
Ensure the patient's tongue/lips are not caught between the
airway and the teeth (Figure 13.5c).
Reassess the patient's airway for patency.
Nasopharyngeal (NP) airway
Similar to an OP airway, the nasopharyngeal (NP) airway is designed
to hold the tongue away from the posterior pharynx (Figure 13.6).
The NP airway consists of the fl ange, the shaft and the bevel
(Figure 13.7). All are made of soft fl exible plastic to prevent trauma
Figure 13.2 A correctly positioned OP airway.
Figure 13.4 Sizing an OP airway. Measured from the incisors to the angle
of the jaw.
Figure 13.3 OP airway showing fl ange, body and tip.