Page 162 - Clinical Application of Mechanical Ventilation

128 Chapter 5

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Figure 5-2 The correct placement of an oropharyngeal airway. Note how the distal tip of the
airway rests at the base of the tongue.

Insertion of Oropharyngeal Airway

Prior to insertion of an oropharyngeal airway, ensure that the patient is sedated or
unconscious. If the patient begins to gag or retch during the procedure, remove the
airway immediately and reassess the necessity of an oropharyngeal airway. Some-
times the airway may be opened and maintained by repositioning of the head (e.g.,
head tilt-chin lift, jaw thrust).
Body fluid or isolation precautions must be observed throughout the procedure. The
patient should be in a supine position, and the mouth is opened using the scissors
(crosses fingers) technique. If a tongue blade is available, the tongue is depressed and the
oropharyngeal airway may be inserted with the pharyngeal curvature. Some practitio-
ners prefer to insert the airway into the patient’s mouth upside down so that the distal
end of the airway is facing the hard palate (roof of the patient’s mouth). As the airway is
inserted fully, it is turned 180° until the flange (proximal end) rests on the patient’s lips
or teeth (White, 2004). The correct placement of an oropharyngeal airway is shown in
Figure 5-2.

NASOphARyNGEAL AIRwAy

The nasopharyngeal airway is a simple airway adjunct that can be used to facilitate
ventilation and removal of secretions. It is also called a nasal trumpet or nasal horn
(White, 2013). A nasopharyngeal airway has advantages over the oropharyngeal airway

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