ETT / Oral Airway

[AliRae]

Not sure where to post this, so I'll stick it in the ED forum, since that's where I saw it. =)

I'm a PICU person who has no ED experience. I'm on the transport team (which I love!), and I went out for a kid yesterday. He was a drug ingestion of some sort (still not sure what) and when we got there, he had deteriorated and was intubated. Besides the ETT, he also had an oral airway taped into his mouth. I'm wondering if anyone knows the rationale for this. I was a little surprised by it, since he had a stable airway (ETT) and the oral airway was right in the centre of his mouth (e.g. not being used as a bite block). Am I missing something? I've been trying to figure out what was going on, and I'm hoping it was maybe an ED thing I'm not aware of. Can anyone shed some light on this for me?

[GilaRRT]

They were most likely using the OPA as a bite block. Why do you think it was not being used as a bite block? I do not understand your rationale.

[AliRae]

They were most likely using the OPA as a bite block. Why do you think it was not being used as a bite block? I do not understand your rationale.

The placement of the thing was odd ... I suppose it could have been being used this way, but it was pretty far back in his throat. Maybe it had slipped back?

[GilaRRT]

Most likely. An OPA will work in a pinch; however, most people advocate using properly sized "tube tamer" type devices. OPA's have a tendancy to dislodge.

[CRNAGAL]

Oral airways can be used as a bite block, it works at the front teeth. My guess is that the placement of the oral airway kept the ETT more stable, since those little ETT are pretty floppy.

[cmo421]

The placement of the thing was odd ... I suppose it could have been being used this way, but it was pretty far back in his throat. Maybe it had slipped back?

Or they could have used the wrong size! They just grabbed what was closest and maybe it was too long. Ususally this is picked up by a Resp. RX and fixed once the pt is stable and sedated.