Basic Airway Adjuncts are discussed in this lesson. The three basic airway adjuncts are each defined. Along with in-depth descriptions, when to use the three basic airway adjuncts is also explained.
"The oropharyngeal airway, or OPA, is a J-shaped device that fits over the tongue to hold the soft hypopharyngeal structures and the tongue away from the posterior wall of pharynx. OPA is used in individuals who are at risk for developing airway obstruction from the tongue or from relaxed upper airway muscle. A properly sized and inserted OPA results in proper alignment with the glottis opening.
If efforts to open the airway fail to provide and maintain a clear, unobstructed airway, then use the OPA in unconscious individuals. You should not use an OPA in conscious or semiconscious individuals because it can stimulate gagging and vomiting, and possibly aspiration. The key assessment is to check whether the individual has an intact cough and gag reflex. If so, then do not use an OPA.
The nasopharyngeal airway, or NPA, is a soft rubber or plastic un-cuffed tube that provides a conduit for airflow between the nares and the pharynx. The NPA is used as an alternative to an OPA in individuals who need a basic airway adjunct. Unlike the oral airway, NPAs may be used in conscious or semiconscious individuals (with intact cough and gag reflex).
Use NPA when insertion of an OPA is technically difficult or dangerous. NPA placement can be facilitated by the use of a lubricant. Never force placement of the NPA as severe nosebleeds may occur. If it does not fit in one nare, try the other side. Use caution or avoid placing NPAs in individuals with obvious facial fractures.
Suctioning is an essential component of maintaining a patent airway. Providers should suction the airway immediately if there are copious secretions, blood, or vomit. Attempts at suctioning should not exceed 10 seconds. To avoid hypoxemia, follow suctioning attempts with a short period of 100 percent oxygen administration.
Monitor the individual’s heart rate, pulse oxygen saturation, and clinical appearance during suctioning. If you see a change in monitoring parameters, then interrupt suctioning and administer oxygen until the heart rate returns to normal and until clinical condition improves. Assist ventilation as warranted."
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