As a registered nurse and first-aid trainer, I’ve encountered a lot of challenging situations. One particularly memorable incident occurred during a local footy match. A player lost consciousness after a severe tackle, and I knew immediately that this scenario was going to require advanced resuscitation techniques. That day, an Oropharyngeal Airway (OPA) proved crucial.
Join me on a journey through the complexities of advanced resuscitation techniques that I teach in our HLTAID015 Provide Advanced Resuscitation and Oxygen Therapy Course at My First Aid Course Brisbane. This blog will feature a series of articles breaking down the components of this course, written in a user friendly fashion – the same way I deliver training.
In this blog, we’ll delve into the often-overlooked yet vital tool, the OPA. Whether you’re a curious bystander, an aspiring healthcare professional, or just someone interested in life-saving techniques, this deep dive will reveal the crucial role it plays in maintaining an open airway when every second matters.
But what exactly is an OPA, and why is it important? Let’s explore this essential piece of first aid equipment.
What are OPAs?
OPA stands for Oropharyngeal Airway, also known as a Guedel airway (it’s older name) after its inventor. It’s a curved plastic tube inserted into an unconscious person’s mouth to keep their airway open. Essentially, it acts as a conduit to ensure air can flow freely.
To understand the function of OPAs, we need a brief anatomy lesson. Don’t worry; I’ll keep it simple! The oropharynx is the part of your throat right at the back of your mouth. It’s where your mouth (oro-) and throat (pharynx) meet. In unconscious individuals, the tongue can relax and obstruct this area. An OPA prevents this obstruction, keeping the airway open.
OPAs come in various sizes to accommodate different patient anatomies, from children to adults.
A Bit of History – random trivia
The concept of maintaining open airways isn’t new. Ancient civilisations attempted rudimentary airway management as far back as 3000 BC. However, the modern OPA as we know it was developed by Dr Hewitt in the early 20th century, only he used a straight rubber and metal tube (imagine the damage to the inside of the mouth and teeth!).
The design was modified by Dr Arthur Guedel in the 1930s. He designed the curved shape we know today, that follows the contours of the throat. It was still made of rubber and metal, though and reused between patients!
Since then, the design (thankfully) has undergone refinements and improvements (and is now single use).
Why Use an OPA?
OPAs are invaluable for unconscious patients without a gag reflex. They prevent the tongue from obstructing the airway and facilitate ventilation if necessary.
Compared to more complex airway devices, OPAs are relatively simple to use, making them ideal for first aid situations where advanced equipment might not be available.
However, it’s crucial to note that OPAs are not suitable for all patients. In individuals with an intact gag reflex, inserting an OPA could induce vomiting, potentially compromising the airway further.
Always assess for a gag reflex before using an OPA (keep reading).
What is the gag reflex?
The gag reflex, also known as the pharyngeal reflex, is a protective mechanism in the human body. It’s an involuntary contraction of the back of the throat that helps prevent choking and keeps potentially harmful substances from entering the airways and lungs.
The gag reflex is triggered when sensitive areas in the mouth and throat are stimulated. These areas include the back of the tongue, the area around the tonsils, the uvula, and the back of the throat. When these areas are touched or irritated, it can cause the muscles in the throat to contract suddenly, producing the gagging sensation.
It’s worth noting that the sensitivity of the gag reflex can vary significantly between individuals. Some people have a very sensitive gag reflex, while others may have a reduced or absent reflex. In the context of first aid and OPAs, checking for the presence of a gag reflex is crucial because fully inserting an OPA.
The easiest way to assess the gag reflex when inserting an OPA is to gradually insert the device (details below), pause for a couple of seconds as the device is turned, if there is no response from the patient it is likely their gag reflex has stopped and they will tolerate full insertion of the device.
How to Insert an OPA
Inserting an OPA requires practice and proper technique. Here’s a step-by-step guide:
- Select the appropriate size OPA by measuring from the corner of the mouth to the earlobe.
- Open the patient’s mouth.
- Insert the OPA inverted, with the curved end towards the hard palate (roof of the mouth).
- Advance the OPA until you meet slight resistance.
- Pause briefly to assess for any response or gag from the patient.
- Rotate it 180 degrees while continuing to insert.
- The flange should rest against the lips when fully inserted.
Common mistakes include forceful insertion, which can damage the soft palate, and improper rotation, which may push the tongue further back. Remember, the goal is to lift the tongue forward, creating a clear airway.
Training and Practice
While understanding the theory is important, practical experience is crucial. At My First Aid Course in Brisbane, we offer comprehensive training in advanced resuscitation techniques, including OPA insertion.
HLTAID015 Provide Advanced Resuscitation and Oxygen Therapy provides hands-on practice with manikins, simulating various scenarios you might encounter in real-life emergencies. We focus on building confidence and muscle memory to ensure you’re prepared for critical situations.
Conclusion
OPAs may seem like simple devices, but they play a vital role in advanced resuscitation techniques. They bridge the gap between basic first aid and professional medical interventions.
Remember, knowledge is power, but practice ensures proficiency. If you’re interested in enhancing your first aid skills, consider joining us for an Advanced Resuscitation course at My First Aid Course, Brisbane. We’re committed to equipping you with the skills and confidence to handle a wide range of emergency situations. You never know, I may just see you there.
Stay prepared, stay safe, and never stop learning!
Further Reading and Resources
https://www.e-safe-anaesthesia.org/sessions/03_02/d/ELFH_Session/14143/tab_14514.html
https://www.britishjournalofnursing.com/content/clinical/intermediate-life-support-for-the-adult
https://www.hmpgloballearningnetwork.com/site/emsworld…….
https://victoriancollections.net.au/items/5d0c181121ea670eac8d330c
https://www.gpcmedical.com/323/DIS102/guedel-airways-oropharyngeal-airways.html
https://www.researchgate.net/figure/Choosing-the-correct-size-of-oropharyngeal-airway_fig4_262812829
