INSERT AN OROPHARYNGEAL AIRWAY IN AN UNCONSCIOUS CASUALTY

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You have already been tested on your ability to open a casualty’s airway and administer mouth-to-mouth resuscitation. Part of the task requires you to keep the casualty’s airway open while you treat other injuries. This may be a problem in an unconscious casualty. You can use one of the oropharyngeal airways in your aid bag to help keep the unconscious casualty’s airway open while you check for injuries.

TASK

Identify procedures for inserting an oropharyngeal airway in an unconscious casualty.

CONDITIONS

Given written items pertaining to the oropharyngeal airway (J-tube) and its use.

STANDARD

Score 70 or more points on the 100-point written examination.

The oropharyngeal airway is only used with an unconscious casualty.

Do not insert the oropharyngeal airway if the casualty is conscious or semiconscious. The airway could cause the casualty to gag and vomit.

Question:

Why would it be dangerous for the casualty to vomit?

Response:

The casualty could inhale some of the vomit which could then obstruct his airway.

Place the oropharyngeal airway along the outside of the casualty’s jaw with one end of the airway at the bottom tip of the casualty’s ear.

Close the casualty’s mouth and bring the other tip of the airway toward the corner of the casualty’s mouth.

The airway should reach from the bottom tip of his ear to the corner of his mouth.

Repeat the steps using the other oropharyngeal airway and choose the one that is nearest the correct size.

Question:

Why is it important that the airway be of the appropriate size?

Response:

If the airway is not the correct size, it could injure the casualty’s throat or even obstruct his airway.

The right size keeps the casualty’s tongue from falling down the back of his throat.

Position the casualty on his back.

Place your thumb and index finger of one hand on the casualty’s upper and lower teeth near a corner of his mouth so the thumb and finger will cross when the casualty’s mouth is opened.

Push your thumb and index finger against the casualty’s upper and lower teeth in a scissors-like motion until his teeth separate and his mouth opens.

If the teeth do not separate, wedge your index finger behind the casualty’s back molars and force the teeth apart.

Place the tip end of the airway into the casualty’s mouth. Make sure the tip is on top of the tongue. Point the tip of the airway up toward the roof of the casualty’s mouth.

Slide the airway along the roof of the casualty’s mouth, following the natural curvature of the tongue.

When the tip of the airway reaches the back of the tongue past the soft palate, rotate the airway 180 degrees so the tip of the airway points toward the casualty’s throat.

Advance the airway until the flange rests against the casualty’s lips.

The airway should now be positioned so the tongue is held in place and will not slide to the back of the casualty’s throat.

Check the casualty’s respirations to make sure he is still breathing adequately and the oropharyngeal airway is not blocking his airway.

Adjust the position of the oropharyngeal airway, if needed.

Question:

Should you tie or tape the airway in place?

Response:

No.

Question:

What should you do if the casualty begins to regain consciousness?

Response:

Remove the airway.

Remember, only use the oropharyngeal airway on an unconscious casualty, never on a conscious or semiconscious casualty.

This lesson is tested in the written multiple-choice examination.