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Guedel airway

Created: 25/4/2010
Updated: 14/5/2010
This resource is sponsored using an educational grant from Intersurgical.


An oropharyngeal airway (also known as a Guedel airway) is an airway adjunct used to maintain a patent airway. The airway prevents the tongue from (either partially or completely) obstructing the airway.

Figure 1: The Guedel airway

The oropharyngeal airway was designed by Arthur E. Guedel, an American anaesthetist (1883-1956).

Oropharyngeal airways come in a variety of sizes, from infant to adult.
Oropharyngeal airways are usually indicated for unconscious patients because there is a high probability that the device would stimulate a conscious or semi-conscious patient's gag reflex. This could cause the patient to vomit and potentially lead to an obstructed airway. Nasopharyngeal airways are mostly used when the patient has a gag reflex, due to the fact that it can be used on a conscious patient, whereas the oropharyngeal cannot.

Guedel airway insertion

The correct size oropharyngeal airway is chosen by measuring against the patient's head (the flange is aligned with the centre of the lips and the tip to the angle of the jaw). The airway is then inserted into the patient's mouth upside down. Once contact is made with the back of the throat, the airway is rotated 180 degrees. In children, the airway is inserted right side up (to avoid trauma to the soft tissues). Oropharyngeal airways are the commonest cause of damage to teeth in anaesthetised patients.

Figure 2: Guedel airway insertion

 Video 1: Placement of a guedel airway

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