Oropharyngeal Airway (OPA) - The OPA is a curved, rigid channel that is placed in the patient's mouth and oropharynx. In addition to manual airway maneuvers, it can provide a patent (unobstructed/clear) airway in the unresponsive patient by supporting the base of the tongue and providing a protected channel.
The main indications for use of an OPA are if a patient is at risk of airway obstruction due to relaxed upper airway muscles or blockage of the airway by the tongue. For example, if you (especially as a solo rescuer) perform a head tilt-chin lift maneuver or jaw thrust on a patient to open their airway and are not able to ventilate the patient successfully, placement of an OPA is indicated.
- Assess the patient's gag reflex - if present, the OPA cannot be used, and consider a NPA.
- Select the correct size for the patient - the device length should equal the measurement from the patients ear lobe to the corner of the mouth.
- Clear the mouth of secretions such as vomit, blood, or sputum using a suction catheter.
- Insert the device with the curve either sideways or towards the roof of the mouth and, once it is well into the mouth, rotate so that the curve is away from the roof of the mouth while advancing it fully into the mouth.
- Settle in place with the flange against the lips and the tip of the OPA retaining the posterior portion of the tongue.
- Reassess airway for adequate breathing, suction as needed and recheck periodically.