Insert an Oral Airway

Oral airways are used only on unconscious patients, to facilitate breathing.

Start by positioning the casualty on his/her back.

Try to open the airway using the head-tilt/chin-lift technique. If a spinal cord injury is suspected, then the jaw-thrust technique can be used.

To maintain an open airway on an unconscious patient, you will likely need to insert an oralpharyngeal airway ("J-tube").

J-tubes come in a range of sizes. If you have several from which to select, choose the one that measures from the corner of the mouth to the tip of the earlobe.

• If the tube is too short, it may be ineffective.

• If the tube is too long, it may obstruct the airway.

If you don't have the right size airway, you can usually make do with whatever you have, but you'll need to pay very close attention to positioning and watch the patient carefully to make sure the airway is working and not obstructing the breathing.

Using your thumb and forefinger, open the mouth of the unconscious victim. Keep the mouth open.

Next, insert the J-tube into the mouth, pointing upward toward the roof of the mouth. Gently push it about half-way into the mouth. Be careful not to push the tongue further back into the casualty's throat.

Then rotate it 180 degrees, so it is facing down toward the trachea, while you slide it the rest of the way into the mouth.You shouldn't have to force it at any time. It normally slides fairly easily into the correct place.

After insertion, watch the casualty closely. The J-tube will be tolerated only so long as the casualty is unconscious. On arousal, the casualty will gag on the airway and may vomit, if it is not removed. Never tape the oral airway in place, as it should be quickly removed if the casualty wakes up.

Never insert an oral airway on a conscious patient for training purposes, as it can provoke gagging, vomiting and possible aspiration. Instead, use a maniken for practice.

Watch a video demonstrating this technique.

Oral airways are used only in unconscious patients. Start by using the head-tilt/chin-lift technique to open the airway. If spinal cord injury is suspected, the jaw-thrust technique may open the airway. There are a range of sizes. The correct size extends from the corner of the mouth to the earlobe. If the airway is too short, it won't hold the tongue out of the way. If it is too long, it may obstruct breathing. Use thumb and forefinger to open the mouth. Insert the tube half-way, curved up toward the soft palate. Then, rotate the tube 180 degrees. Proper final placement has the tube facing down towards the trachea. Externally, the properly-sized tube, correctly placed, looks like this.

This material is based on "Insert an Oropharyngeal Airway," A1701-93-000156, produced by the Health Sciences Media Division, US Army Medical Department C&S, Fort Sam Houston, Texas.

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