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Basic Airways

September 26, 2019


Now let’s talk a little bit about basic
airways. In this case, the patient is unresponsive. We could check for a reflex, or a gag reflex,
by maybe rubbing the eyelid to see if they actually have a blinking reflex, that’s
one little trick of the trade. If they did seem to have a gag reflex, I would
opt for a nasopharyngeal airway, they tolerate it while they are still semiconscious. The way to measure it is from the edge of
the nostril or the nare to the earlobe. In this case, you can see this nasopharyngeal
tube would be about the right size. But because I believe that this patient is
unresponsive, and they probably don’t have a gag reflex, I am going to do a head-tilt
chin-lift, and I am going to prepare to use what we call an OPA or an oropharyngeal airway. I want to make sure that I have either portable
suction, or a battery operated or a regular concurrent suction catheter available, because
once we begin to actually put this oropharyngeal airway in, if they do have a gag reflex, that’s
when they may vomit, or as I look in there, they may actually have blood, mucus, or something
else in the back that I want to suction. It’s important to realize that when we do
suction, we don’t want to suction for any longer than ten seconds at a time before we
oxygenate them again. So, in measuring this oropharyngeal airway,
we’re going to go from the corner of the mouth to the earlobe. As you can see this red oropharyngeal airway
is a little long. I try the next size down, and it’s just
about spot on perfect. The procedure for putting the OPA in, is to
invert the tube so that the end of it follows the roof of the mouth until it starts to get
closer to the back of the oropharynx. I then twist it, as it goes in it helps to
move the tongue out of the way bringing it forward and allowing me to put air behind
the tongue and into the lungs.

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