An oropharyngeal airway is a device used in emergency medicine, specifically prehospital care (ambulance/EMT). An oropharyngeal airway is a device made of plastic, which is designed to fit into the mouth of an unconscious person to hold the tongue up and away from the back of the throat. This is important because the most common cause of airway obstruction in an unconscious patient is the relaxed tongue falling backwards and blocking the flow of air.

Oropharyngeal (OP) airways are generally shaped like a capital 'J', with less curvature to the base. They have a flange which is designed to rest against the front of the teeth. There are two types of OP airways: one is basically shaped like an I-beam - a flat top and bottom, with a ridge of plastic connecting them in the middle. This allows suction catheters to be passed down the side of the airway if suctioning becomes necessary. The other is a hollow J-shaped rigid tube of plastic, so that a catheter can be passed down the middle.

OP airways come in sets of different sizes. Choosing the proper size is important, as a too small one will not hold the tongue out of the way, and a too large one may obstruct the airway itself. The proper way to measure an oropharyngeal airway is to lay the flange at the corner of the patient's mouth. If the tip of the airway touches the earlobe, the size is correct.

In an adult, an OP airway should be inserted upside down, then given a 180 degree turn. This is done to prevent the tip of the airway unintentionally pushing the tongue farther back. In infants and children, however, this must not be done due to their more delicate and easily damaged oral tissue. If necessary, the tongue may be grasped using a piece of gauze and gently pulled forward during insertion.

Once the patient shows signs of returning consciousness, the oropharyngeal airway must be removed immediately in order not to stimulate the gag reflex. Trust me, the last thing you want a patient with airway problems to do is vomit...

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