The oropharyngeal airway (OPA) and nasopharyngeal airway (NPA) are basic airway adjuncts. They are designed to secure the airway once it has been opened by either a head-tilt, chin-lift or jaw-thrust manuever, and any objects or secretions have been removed by suctioning. The OPA and NPA keep the tongue from occluding the airway and extend to, but do not pass the larynx.

Oropharyngeal Airway (OPA)

The OPA comes in two forms: one is tubular with a hollow center and the other has channeled sides. Both types of OPA’s allow for suctioning and come in various sizes for infants, children and adults.

Indications

• Unresponsive patient with no gag reflex

Contraindications

• Responsive patient or has a gag reflex

How to Insert

1. Select an OPA and measure from the level of the teeth to the angle of the jaw.
2. Open the patient’s mouth by using the crossed-finger or scissor technique.
3. Insert the OPA upside down and when it touches the roof of the back of the mouth, rotate it 180 degrees while continuing to advance the airway until the flange is resting on the patient’s front teeth. You can also insert the OPA sideways and rotate it 90 degrees.

Remove the OPA immediately if the patient becomes responsive or begins to gag.

Nasopharyngeal Airway (NPA)

The NPA comes in various sizes based on the diameter of the tube and allows for suctioning as well.

Indications

• Unresponsive patient with a gag reflex
• Patient will not tolerate an OPA
• Patient has clenched teeth

Contraindications

• Responsive patient
• Suspected fracture to the base of the skull or mid-face

How to Insert

1. Select a NPA and measure from the tip of the nose to the tip of the earlobe.
2. Lubricate the NPA with a sterile, water-soluble lubricant.
3. Insert the NPA with bevel facing the septum and continue until the flange is resting on the the flare of the nostril. If you meet resistance, gently rotate the NPA from side to side and continue to insert. If you still meet resistance, remove the NPA and try inserting in the other nostril.

A head-tilt, chin-lift or jaw-thrust maneuver must still be maintained, even when an OPA or NPA is inserted.