Page 161 - Clinical Application of Mechanical Ventilation

Special Airways for Ventilation 127

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Figure 5-1 A variety of oropharyngeal ariways. Berman airways, a Guedel airway, and a
Cath-Guide Guedel airway are shown.

TABLE 5-1 Size Chart for Berman and Guedel Oropharyngeal Airways

Extra-Large Large Medium Small
Adult Adult Adult Adult Child Infant

Berman 110 mm 100 mm 90 mm 80 mm 60 mm 43 mm
Guedel 120 mm 110 mm 100 mm 80 mm 60, 70 mm 55 mm
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110 mm for extra-large adults. The common Guedel airway has one large internal
channel and the Cath-Guide Guedel has three internal channels. Guedel airways
have sizes ranging from 55 mm for infants to 120 mm for extra-large adults. (See
Table 5-1.)

Selection of Oropharyngeal Airway

The appropriate size (from flange to distal tip) of an oropharyngeal airway may
The appropriate size of an be estimated based on the length in millimeters from the center of the mouth to
oropharyngeal airway may be
estimated by the distance from the angle of the jaw. Alternatively, the length in millimeters from the corner of the
the center of the mouth (or mouth to the earlobe may be used. The third method is to measure the distance
central incisors) to the angle of
the jaw or from the corner of from the central incisors to the angle of the jaw. To evaluate the size using this
the mouth to the earlobe.
method, place the airway next to the patient’s face.
Proper sizing for the patient is important. If the airway is too large, it may push
the epiglottis against the larynx leading to airway obstruction. If the airway is too
small, the tongue may not be sufficiently moved away from the soft palate leading
to airway obstruction by the tongue.

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