Guedel oropharyngeal airway, also known as Guedel airway or Guedel tube, is a medical device used to maintain an open airway in unconscious or sedated patients. It is commonly used during anesthesia administration, resuscitation, and in emergency situations.
The Guedel airway is a rigid plastic tube with a curved shape that is inserted into the patient's mouth and extends into the oropharynx. It is designed to prevent the tongue from obstructing the airway and to facilitate the passage of air and gases. The device has a flange or bite block at the proximal end, which helps to keep it in place and prevents it from being inserted too far into the patient's mouth.

The Guedel airway is available in various sizes to accommodate different patient age groups, ranging from infants to adults. The correct size is chosen based on the patient's anatomical characteristics, such as the distance from the corner of the mouth to the angle of the jaw.
To insert a Guedel airway, the patient's head is placed in a neutral position, and the mouth is opened. The device is inserted gently, with the curved tip facing the roof of the mouth. Once in place, it helps to keep the patient's tongue forward, preventing it from blocking the airway and allowing for easier ventilation.
It is important to note that the Guedel airway does not protect the patient's airway from aspiration of fluids or solids. Therefore, it should not be used in patients with a gag reflex or in situations where the patient is at risk of vomiting. Additionally, proper monitoring and frequent assessment of the patient's airway are essential when using the Guedel airway to ensure its effectiveness and patient safety.
As always, healthcare professionals should be consulted for proper insertion, sizing, and use of the Guedel oropharyngeal airway, as well as for any specific guidance or protocols in their clinical setting.

How to use Guedel Oropharyngeal Airway?
To use a Guedel oropharyngeal airway, follow these general steps:
Select the appropriate size: Choose the size of the Guedel airway based on the patient's age and anatomical characteristics. The airway should be long enough to reach from the corner of the mouth to the angle of the jaw without being inserted too deeply.
Prepare the patient: Position the patient's head in a neutral position, aligning the oral, pharyngeal, and tracheal axes. Open the patient's mouth by using a tongue depressor or jaw thrust technique if necessary.
Lubricate the airway: Apply a water-based lubricant to the Guedel airway to facilitate smooth insertion.
Insert the airway: Hold the Guedel airway with the curved tip facing upwards. Insert the airway into the mouth, following the natural curve of the tongue. Gently advance the airway along the roof of the mouth until it reaches the back of the throat (oropharynx). Avoid forcing or causing any trauma during insertion.
Rotate the airway: Once the airway is fully inserted, rotate it 180 degrees so that the curved tip faces downwards, resting against the soft palate. This helps prevent the tongue from blocking the airway.
Confirm proper placement: Ensure that the Guedel airway is not inserted too deeply or not deep enough. The flange or bite block of the airway should sit just outside the patient's lips, and the patient's teeth should be positioned between the bite block and the airway shaft.
Secure the airway: If necessary, secure the Guedel airway in place by using medical tape or other appropriate methods. This helps prevent accidental dislodgement.
Monitor the patient: Continuously monitor the patient's airway, breathing, and oxygenation. Observe for any signs of airway obstruction or complications.
Remember, the use of the Guedel oropharyngeal airway should be performed by trained healthcare professionals who are familiar with airway management techniques. It is important to follow institutional guidelines and protocols specific to your clinical setting.

Positioning for Oropharyngeal Airway

1. The sniffing position—only in the absence of cervical spine injury.
2. Position the patient supine on the stretcher.
3. Align the upper airway for optimal air passage by placing the patient into a proper sniffing position. Proper sniffing position aligns the external auditory canal with the sternal notch. To achieve the sniffing position, folded towels or other materials may need to be placed under the head, neck, or shoulders, so that the neck is flexed on the body and the head is extended on the neck. In obese patients, many folded towels or a commercial ramp device may be needed to sufficiently elevate the shoulders and neck. In children, padding is usually needed behind the shoulders to accommodate the enlarged occiput.

If cervical spine injury is a possibility:

• Position the patient supine or at a slight incline on the stretcher.
• Avoid moving the neck and use only the jaw-thrust maneuver or chin lift without head tilt to manually facilitate opening of the upper airway.