Oral Airway Insertion

Insertion of an oral airway

Insertion of an oral airway in a conscious or semiconscious patient stimulates the gag reflex and may stimulate airway spasm or cause the patient to retch and to vomit.2 To avoid vomiting and aspiration, the oropharyngeal airway should be removed immediately after the patient regains a gag reflex.

Perform hand hygiene and apply gloves. 
  • Verify patient's identity in accordance with institutional policy. 
  • Ensure that the patient is unconscious and has no gag reflex. 
  • Place the patient in the supine position. 
  • Suction blood, secretions, or other foreign material from the patient's oropharynx. 
  • Select the appropriately sized oropharyngeal airway. Align the tube on the side of the patient's face and choose an airway that extends from the level of the central incisors with the bite block portion parallel to the hard palate. The tip of the appropriate size airway will meet the angle of the jaw. 
  • Use a tongue blade to depress and displace the tongue forward. Insert the airway with the curve pointing up, and advance it over the tongue into the oropharynx. 
  • As an alternative procedure for adults and adolescents, insert the airway upside-down (with the curve pointing toward the back of the patient's head) into the mouth. As the tip of the airway reaches the posterior wall of the pharynx, rotate the airway 180 degrees to the proper position. (NOTE: This technique is contraindicated in children.) 
  • Ensure that the distal tip of the airway lies between the base of the tongue and the back of the throat. The flange of the tube should sit comfortably on the lips. 
  • Reassess the airway patency and auscultate the lungs for equal and clear breath sounds during ventilation. 
  • Monitor for change in level of consciousness and presence of the gag reflex. 
  • Ensure the oropharyngeal airway is removed immediately after the patient regains the gag reflex. 
  • Document the procedure in the patient's record.
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