Guedel Airway Sizes: Size Chart (0, 2, 3, 4, 5), Uses, Insertion Technique, Tubes, and Airway Kit

Guedel Airway Sizes:

• What is Guedel Airway?
• Size Chart (0, 2, 3, 4, 5)
• Uses
• Insertion Technique
• Tubes
• Airway Kit

What is Guedel Airway?

The Guedel airway, also known as an oropharyngeal airway, is a medical device used to maintain a patent airway in patients who are unconscious or unable to maintain their own airway. It prevents the tongue from falling back and obstructing the oropharynx, which is crucial during anesthesia, resuscitation, or emergency situations. Guedel airways are widely used in hospitals, ambulances, and emergency settings as a first-line airway management tool.

The device is typically made of plastic and comes in various sizes to accommodate infants, children, and adults. It is easy to insert, non-invasive, and does not require specialized skills, making it ideal for both pre-hospital and in-hospital use. Proper sizing and technique are critical to avoid complications such as airway trauma or gag reflex activation.

Size Chart (0, 2, 3, 4, 5)

Guedel airways come in multiple sizes, typically numbered 0 through 5, corresponding to patient age and anatomy. The sizes are generally as follows: 

Guedel Airway Size Chart

Size (Number)	Approx. Length (mm)	Color Code	Typical Patient Category
000	35 - 40 mm	Pink (or Light Green)	Premature Infant / Neonate
00	40 - 50 mm	Blue	Neonate / Infant
0	50 - 60 mm	Black (or Grey)	Infant / Small Child
1	60 - 70 mm	White (or Brown)	Child
2	70 - 80 mm	Green	Small Adult / Adolescent
3	80 - 90 mm	Yellow	Medium Adult
4	90 - 100 mm	Red	Large Adult
5	100 - 110 mm	Orange	Extra Large Adult
6	110 - 120 mm	Purple	Extra Large Adult

Correct sizing is essential for effectiveness. An airway that is too short may not prevent tongue obstruction, while one that is too long can cause trauma to the pharynx or larynx. Most providers measure from the corner of the patient’s mouth to the angle of the jaw to determine appropriate size.

Uses

Guedel airways are primarily used to maintain airway patency in unconscious or sedated patients. They are commonly utilized during anesthesia induction, CPR, and emergency airway management. They are also used to assist in suctioning secretions and as a conduit for bag-mask ventilation. In addition, Guedel airways can help prevent airway obstruction in patients with reduced muscle tone or neurological impairment.

The device is versatile and provides a temporary solution until more definitive airway management, such as endotracheal intubation, can be performed. While it is effective for short-term airway support, it is contraindicated in conscious patients because it can trigger gagging or vomiting.

Insertion Technique

The insertion of a Guedel airway requires proper technique to avoid injury. For adults and children, the airway is initially inserted upside down (concave facing the roof of the mouth) and then rotated 180 degrees as it reaches the oropharynx. This technique helps prevent pushing the tongue back and avoids trauma.

In infants and small children, the airway is often inserted with the curve facing downward directly into the mouth without rotation. The device should be gently advanced until the flange rests against the lips. Proper technique ensures effective airway maintenance and minimizes complications such as laceration, gag reflex, or dental injury.

Tubes

Guedel airways are available in single-use plastic tubes or reusable sterilizable versions. They are typically color-coded by size for quick identification in emergencies. The tubes are rigid but flexible enough to follow the oropharyngeal curve, allowing easy insertion while reducing the risk of soft tissue injury.

Some modern tubes have additional features, such as bite blocks or connectors for oxygen supplementation. These enhancements improve patient safety and facilitate integrated airway management during resuscitation or anesthesia procedures.

Airway Kit

A typical airway kit includes multiple sizes of Guedel airways, suction devices, and bag-mask ventilation equipment. The kit is designed for rapid response in emergency or surgical settings, providing all necessary tools for maintaining airway patency. Kits are usually compact and organized for easy access during critical situations.

Proper training in the use of airway kits, including selection, sizing, and insertion of Guedel airways, is essential for healthcare providers. Regular checks and replacement of expired or damaged equipment ensure readiness for emergencies and effective airway management.