Advanced Medical Certification

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Basic Airway Protocols

Inserting an OPA

Step 1: Clean blood and secretions from the mouth with suction.

Step 2: Choose an appropriately sized airway device.

  • Too large and you risk damaging the throat
  • Too small and you risk forcing the tongue into the airway

Step 3: The device must be placed beside the person’s face. Extend the device from the earlobe to the corner of the mouth.

Step 4: The device must be positioned in the mouth so that the tip is pointed toward the mouth’s roof or in line with the teeth.

  • Make sure the tongue is not pushed to the throat.

Step 5: When the device is almost completely inserted, twist it until the tongue is cupped inside by the curve of the device.

Inserting a NPA

Step 1: Chose an appropriately sized airway device.

Step 2: The device must be placed beside the person’s face. It must extend from the earlobe to the tip of the nose. Make sure to apply the largest diameter device that can fit.

Step 3: Use a water-soluble lubricant or an anesthetic jelly, when available, to lubricate the airway.

Step 4: The device must move into the face, not toward the brain, and must be inserted slowly.

Step 5: There should be a snug fit, but the device should not be forced into the nostril. Try the other nostril if the device feels stuck.

Tips on Sunctioning

  • Avoid inserting the catheter too deeply as you suction the oropharynx. The maximum safe depth must be used by the catheter, and you should countiue suctioning while you withdraw.
  • For an endotracheal (ET) tube, remember that while suctioning, the tube is inside the trachea, and you can possibly suction near the lung or bronchi. Sterile techniques must therefore be used.
  • Do not suction longer than 10 seconds for each attempt. Keep in mind that during suctioning, the patient should not get oxygen.
  • Stop suctioning if vital signs change during suctioning, and especially if the patient becomes cyanotic, develops a new arrhythmia, or experiences hypoxemia.
Take Note
  • OPAs can block the airway if they are too small or large.
  • Inappropriately sized NPAs can enter the esophagus.
  • Be alert for spontaneous respirations after inserting either device.
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