The cuffed oropharyngeal airway in resuscitation

The cuffed oropharyngeal airway (COPA, Mallinckrodt) may prove a useful airway adjunct in resuscitation by non-anaesthetists. Many hospital workers are familiar with the standard oropharyngeal airway but find it difficult to use with a face-mask to provide effective positive pressure ventilation of the lungs. However, most inexperienced hospital basic life support providers can use the COPA effectively with minimal instruction. Recommended COPA size and cuff volumes for manual ventilation in adult males and females are respectively size 11 and 10 with up to 60 ml and 50 ml in each cuff. Simple airway manoeuvres taught in basic life support (lifting the chin, tilting back the head) also apply to use of the COPA. A leak around the cuff is common but does not usually impair the ability to ventilate the lungs. Future developments may include more widespread evaluation of the COPA in resuscitation and direct comparisons with other devices.