Blind insertion airway device (BIAD, blind insertion device) is a device used for airway Mx, that ensures an open pathway between a patient's lungs and the outside world, as well as reducing the risk of aspiration, which can be placed without visualization of the glottis.
Purpose
They are often used in the pre-hospital and emergency setting
Classification
Laryngeal mask airway (LMA), is composed of an airway tube tht connects to an elliptical mask with a cuff which is inserted through the Pt's mouth, down the windpipe, and once deployed forms an airtight seal on top of the glottis [unlike tracheal tubes which pass through the glottis], thereby securing the airway. It is used by anesthetists to channel O2 or anesthesia gas to a Pt's lungs during surgery and in the pre-hospital setting for unconscious Pt's
Nasopharyngeal airway (aka NPA, nasal trumpet, nose hose), is a tube designed to be inserted into the nasal passageway to secure an open airway. When a patient becomes unconscious, the muscle sin the jaw commonly relax and can allow the otngue to slide back and obstruct the airway. The purpose of the flared end is to prevent the device from becoming lost inside the patient's nose. The correct size is measured from the tip of the nose to the tragus of the ear. The suitable diameter is one that fits just into the nostril, without causing sustained blanching of the alae nasi. Do not use a nasopharyngeal airway if there is possibility of fracture of the base of the skull
Oropharyngeal airway (aka oral airway, OPA, Guedel pattern airway) prevents the tongue from covering the epiglottis, which could prevent the person from breathing. When a patient becomes unconscious, the muscles in their jaw relax and allow the tongue to obstruct the airway. It should only be used on onconscious or obtunded patients, as if the patient is awake with an intact gag reflex, it may not be tolerated and induce vomiting. The correct size is measured from the center of the incisors, to the angle of the jaw/mandible. Ensure the Guedel follows the natural curvature of airway, with direct visualization. If inserted blindly, insert it upside down, and twist it to follow the curve once in. A tongue depressor or laryngoscope blade can help hold the tongue out of the way during insertion
Laryngeal tube, is inserted blindly through the oropharynx into the hypopharynx to create an airway during anesthesia and CPR so as to enable mechanical ventilation of the lungs
Combitube (aka esophageal tracheal airway, esophageal tracheal double-lumen airway), is a cuffed, double-lumen tube that is inserted through the patients mouth to secure an airway and enable ventilation. Generally, the distal (tube 2) enters the esophagus, where the cuff is inflated and ventilation is provided through the proximal tube (tube 1), which opens at the level of the larynx
Disadvantage
Risk of aspiration is higher than using endotracheal intubation
See also
Endotracheal tube, although this can too be blindly inserted in ertain circumstances
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