Berman Oropharyngeal Airway Kit (OPA)

What is the difference between a Berman OPA and a Guedel OPA?

Both are oropharyngeal airways designed to hold the tongue away from the posterior pharynx, but they differ in their airway lumen design. A Berman OPA has open channels down each side (dual lateral channels), providing unobstructed air passage and easy suction catheter access from multiple angles. A Guedel OPA has a single center-bore tube running through the middle. The Berman design's open-sided channels may provide more consistent airway patency if the device shifts position. Both are in widespread clinical use — selection often comes down to provider training and institutional preference.

Can I use an OPA on a patient who has a gag reflex?

No. Oropharyngeal airways are contraindicated in conscious and semi-conscious patients with an intact gag reflex. Inserting an OPA in such a patient will typically trigger severe gagging and vomiting, which can cause aspiration — a potentially fatal complication. The OPA should only be used in deeply unconscious patients without a protective gag reflex. For conscious, semi-conscious, or any patient with any gag reflex, use a nasopharyngeal airway (NPA) instead.

How do I select the correct OPA size?

The correct OPA size is estimated by measuring from the corner of the patient's mouth to the earlobe (or corner of mouth to center of ear). Alternatively, hold the OPA against the patient's face — the correct size should reach from the mouth corner to the angle of the jaw. Using the color coding, select the appropriate size based on this measurement. An OPA that is too long may push the epiglottis down and cause obstruction; one that is too short may not effectively displace the tongue.

Is the Berman OPA kit appropriate for pediatric patients?

The kit includes smaller sizes (starting from approximately 60mm) that can be used for pediatric patients. The 60–70mm sizes are appropriate for children. Proper sizing is particularly important in pediatric patients as the margin for error is smaller. Color coding facilitates rapid size selection across patient sizes from child through large adult, making the multi-size kit appropriate for EMS and emergency settings that see mixed patient populations.

Does the OPA replace the need for a BVM or oxygen?

No. The OPA maintains airway patency by holding the tongue and soft tissue away from the pharynx, but it does not provide ventilation on its own. An unconscious patient who requires assisted breathing still needs a bag valve mask (BVM) and supplemental oxygen if available. The OPA serves as an adjunct that improves the effectiveness of BVM ventilation by maintaining the airway open — it is one component of a complete BLS airway management approach, not a standalone intervention.