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The oropharyngeal airway was designed by Arthur Guedel. [2]Oropharyngeal airways come in a variety of sizes, from infant to adult, and are used commonly in pre-hospital emergency care and for short term airway management post anaesthetic or when manual methods are inadequate to maintain an open airway.
The upper airways or upper respiratory tract includes the nose and nasal passages, paranasal sinuses, the pharynx, and the portion of the larynx above the vocal folds (cords). The lower airways or lower respiratory tract includes the portion of the larynx below the vocal folds, trachea, bronchi and bronchioles.
Airway obstruction is commonly caused by the tongue, the airways itself, foreign bodies or materials from the body itself, such as blood or vomit. [ 2 ] Contrary to advanced airway management , basic airway management technique do not rely on the use of invasive medical equipment and can be performed with less training.
The HACEK organisms (Haemophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella) are part of the normal oropharyngeal flora, which grow slowly, prefer a carbon dioxide-enriched atmosphere, and share an enhanced capacity to produce endocardial infections, especially in young children. [5]
A model of an oropharyngeal airway (OPA) preventing the tongue from obstructing the airway. An oropharyngeal airway (OPA) is a rigid tube that is inserted into the mouth through the oropharynx and placed above the tongue to move it away from the back of the throat. [2] [4] They are more commonly used than nasopharyngeal airways (NPAs). [4]
An oropharyngeal airway is acceptable, however nasopharyngeal airways should be avoided in trauma, particularly if a basilar skull fracture is suspected. [42] Endotracheal intubation carries with it many risks, particularly when paralytics are used, as maintenance of the airway becomes a challenge if intubation fails.
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Airway obstruction is also common in people who have suffered smoke inhalation or burns within or near the airway or epiglottitis. Sustained generalized seizure activity and angioedema are other common causes of life-threatening airway obstruction which may require tracheal intubation to secure the airway.