An open airway in an unconscious patient or the patient with a reduced state of consciousness is something of great importance in emergency medicine. One of the most frequently used aids in such cases is the Guedel Airway, commonly known as an oropharyngeal airway (OPA). The device is not sophisticated; however, selection of the right-sized aid for patient management is important. This article will be writing about how to size a Guedel airway and why that sizing matters.
What is a Guedel Airway?
A Guedel airway is a rigid, curtved plastic tube that keeps the tongue from obstructing the airway so that air can enter the lungs freely. It is most often used during resuscitation; in patients under anesthesia; or where the patient is unconscious and cannot keep the airway open for himself. The tube has a bite-resistant block to prevent the teeth clenching down to occlude the airway.
Why is the Right Guedel Airway Size Important?
Proper selection of a Guedel airway is important to ensure that there would be no obstruction in the airway. Ineffective complications arise from a lousy fit airway, including:
- Too Small: If it is too short, the airway will not reach far enough to keep the tongue off of the posterior pharyngeal wall. This means that there will be an ineffective airway.
- Too Large: If it is too long, it could possibly push the epiglottis down and potentially obstruct the airway instead of holding it open.
How to Select the Right Guedel Airway Size
Generally, Guedel airway measures are in millimeters and range from 00 for infants to 6 for large adults. Measurement should therefore include the measurement of distance from incisors up to the angle of the jaw.
Selecting the Right Size Step-by-Step Procedure
- Measure: Place the airway along the side of the patient’s face. The airway should extend from the center of the mouth (between the incisors) to the angle of the jaw.
- Choose the Correct Size: Airway sizes are color-coded for easy identification:
- Size 00: 40mm (neonates)
- Size 1: 60mm (children)
- Size 2: 80mm (small adults)
- Size 3: 90mm (medium adults)
- Size 4: 100mm (large adults)
- Size 5: 110mm (very large adults).
- Insertion Technique: For adults, insert the airway upside down and rotate it 180 degrees once it passes the hard-soft palate junction. This prevents the tongue from being pushed back. For children, insert it directly without rotating.
When to Avoid Using a Guedel Airway
While the Guedel airway is an essential tool in many medical scenarios, it isn’t suitable for all patients. Avoid using it in the following cases:
- Conscious Patients: The airway will trigger the gag reflex, leading to choking or vomiting.
- Patients with Oral Trauma: Patients with injuries such as a broken jaw or oral trauma should not use a Guedel airway as it may cause further damage.
Potential Complications
Like any medical device, improper use of a Guedel airway can lead to complications, including:
- Soft Tissue Trauma: Improper insertion can damage the soft tissues of the mouth, tongue, and palate.
- Gagging and Aspiration: In patients who are partially conscious, the airway may trigger gagging and vomiting, increasing the risk of aspiration.
- Obstruction: An improperly sized airway can lead to airway obstruction rather than keeping the airway open.
FAQ’s
1. How to split 2 columns in Google Docs?
To split text into two columns in Google Docs:
- Open your Google Docs document.
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- Go to the menu bar and click on Format.
- Select Columns from the dropdown menu.
- Choose the two-column option from the displayed options.
You can also customize the columns by selecting “More options” to adjust the spacing and add a line between columns.
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Conclusion
The selection of the appropriate size of the Guedel airway is small but vital to successful airway management. With appropriate sizing techniques and proper insertion of the Guedel airway, healthcare professionals may reduce complications and protect their patients. A patient’s condition should first be assessed and measured accordingly by using the correct technique for better care provision.
