It's called the lingual frenulum.

Jim, are you saying that you would insert an OPA/NPA on a patient having a seizure?

Just wondering...

I have seen more than one bitten tongue from a Seizure. I have never seen a bitten tongue cause more than a bleeding problem. I have seen a few tongue tips bitten off, but again it is never more than a bleeding issue.

The absolute best thing to do for a patient that is seizing is protect them from doing any more harm to themselves from their surroundings. Don't put anything in their mouth while they are seizing... if you need to secure an airway while they are postictal then manual airway management (head tilt) is usually all you need.

Bee, an NPA would probably not hurt a seizing patient if you could actually get one in safely… but you would be wasting your time. It isn’t an airway issue that causes seizing patients to become hypoxic. Placing anything in a seizing patient’s airway is more likely to cause a foreign body airway obstruction then it is to do any good.

As OBG stated, “swallowing the tongue” isn’t actually that. It refers to the tongue relaxing a causing it to occlude the airway. Normally our gag-reflex prevents this, but an unconscious person’s gag reflex can be compromised. An OPA does help prevent this, but a proper head-tilt or modified jaw thrust method or manual airway management is the most effective basic airway management with an OPA or NPA as an adjunct after one of those airway maneuvers has been performed. OPAs and NPAs do require special training but are very simple and many area’s are including their training in first responder classes (a 40-60 hour course) if someone is interested in gaining that additional training.

As for tearing the lingual frenulum, it is very rare in adults… and usually the least of their worries.

OH, I do currently both work in the field on a busy paramedic unit and am the lead instructor of a paramedic training program.

As Col. Potter would say Buffalo Biscuits! It may not be scientifically proven... but it works (from personal experience). You can always go back into the surf to wash off (if you dare).



Best advice from this whole thread!

However... don't rule-out the usefulness of a tourniquet in the right situation. When needed, tourniquets SAVE LIVES and you will probably see an increase in their popularity in austere/remote medicine in years to come. Sure, pressure and shock management with a speedy trip to a surgeon is the preferred management of a major bleed… but the speedy trip to a surgeon isn’t always an option.

Disclaimer to all: DON’T DO ANYTHING YOU HAVEN’T BEEN TRAINED TO DO or ANYTHING THAT IS NOT WITHIN YOUR SCOPE OF PRACTICE!...

I didn't say that. I just mentioned that a swallowed tongue is rare, but it can happen when you insert a Guedel airway the wrong way.
Then OBG replied in his post:
After that I said that a Guedel airway is the same as a OPA.

Maybe it was a bit confusing, but I didn't say anything about inserting a OPA in a victim with a seizure..

Thanks for speaking up Allen, Always nice to hear from the pros!
Stay safe.

Yeah, OBG, we do. Mainly, though, OPA's are used as an adjunct during CPR. Though, yeah, they can be used as a bite block.


Jim... the tongue belt is the lingual frenulum. As opposed to the labial frenulums (the little pieces that connect your lips to your jaws).