lcp
We have detected you are using Internet Explorer. To provide the best and most secure experience, please use a modern browser as we do not support Internet Explorer.

Oropharyngeal Airways in Paediatric Patients

17 March 2020 - Susan Helmrich

Oropharyngeal airways (OPAs) are useful in maintaining airway patency in unconscious patients of all ages. OPAs are often referred to as a Guedel's airways, after the American physician who developed them. These devices are useful adjuncts in unconscious patients, but do carry risks if not sized or inserted correctly.

General paediatric airway considerations:

  • Appropriate sizing requires access to the full range of OPA sizes to ensure the correct one is used based on the anatomical structures of the child or infant.  
  • Prior to insertion remove visible debris from the oropharynx via suction, avoid extended periods of suctioning to minimise the risk of bradycardia.  
  • Do not perform blind finger sweeps in children, as this can force a foreign body further down the airway and completely occlude at the level of the cricoid ring. 
  • Be aware of loose dentition, as school aged children may have loose teeth that can become dislodged in the airway. 

When inserting an OPA in children under 8-years-old:

  • Sizing is important: measure from the centre of the incisors to the angle of the mandible
  • Use a tongue depressor to assist in insertion: in paediatrics this is needed to ensure the tongue is not pushed back by the oropharyngeal airway 
  • Insert the oropharyngeal airway gently: insert under direct vision, putting the oropharyngeal airway in concave side down. This is to avoid damaging the soft palate.
  • Continue to use jaw thrust after insertion, to maximise airway patency
  • Hold the head in the appropriate position for the age of the patient: neutral position for infants under 12 months of age, and the slight sniffing position for children aged over 1 year 

If you are interested in updating your knowledge and confidence in paediatric airway management, you may be interested in attending our Paediatric Advanced Life Support courses These workshops utilise a simulation based approach and are based upon the current Australian Resuscitation Council guidelines. 

For a full list of events and courses please visit https://medcast.com.au/courses

 

References:

Australian and New Zealand Council on Resuscitation (ANZCOR)  ANZCOR Guideline 12.6 – Introduction to Paediatric Advanced Life Support Techniques in Paediatric Advanced Life Support. 

Hambrecht, K. (2019). Cardiopulmonary resuscitation: basic and advanced life support.  Chapter 70 in Brown, D., Edwards, H., Buckley, T., and Aitken, R.L. (eds.). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. (5th edn.). Elsevier: Chatswood.

Royal Children’s Hospital Melbourne (RCH) 2019, The Paediatric Trauma Manual: Airway Procedures.

 

Content reviewed 2/2025

Susan Helmrich
Susan Helmrich

Susan is the Head of Nursing Education for the Medcast Group.

DipAppScNsg, BN, CritCareCert, CoronaryCareCert, TraumaNsgCareCert, CertIV(TAE), MN(Ed), and GradCert(Ldrshp & Mgt).

Get Medcast Plus

Become a member and get unlimited access to 100s of hours of premium education.

Learn more
Related News
Business Skills: GPCCMP plans in practice

Medcast Medical Education Team

Brand icon

New MBS items for GP chronic condition management plans (GPCCMPs) came into effect on July 1st 2025. This Business Skills FastTrack is designed to update GP practice owners and locums about the new GPCCMP item numbers, ensuring you maximise your billing practices without compromising on compliance. 30mins each RP and EA CPD available.

10 mins READ
Lung cancer: screening, diagnosis, and investigation - clinical fact sheet and MCQ

Medcast Medical Education Team

Brand icon

GPs play a critical role in identifying patients with a suspicion of lung cancer. This FastTrack fact sheet covers screening, diagnosis, and investigation of lung cancer in primary care, including updates on the new National Lung Cancer Screening program. Earn 30mins each of RP and EA CPD with the quiz.

10 mins READ
When intuition speaks: the evidence behind listening to caregivers

Grace Larson

Caregiver concern is a powerful predictor of clinical deterioration in children, often surpassing abnormal vital signs. A recent Lancet study confirms its association with ICU admission and ventilation. Integrating caregiver input into assessments, documentation, and escalation protocols can significantly improve early recognition and outcomes in paediatric emergency care.

15 mins READ