An unresponsive patient without a gag reflex. Which airway adjunct is appropriate to maintain patency?

• A. Nasal airway
• B. Bag-valve mask
• C. Oropharyngeal airway
• D. Nasal cannula oxygen

Answer: (C)

When an unresponsive patient has no gag reflex, the tongue is the usual cause of airway obstruction. The oropharyngeal airway is the right adjunct because it sits in the back of the mouth and holds the tongue forward, preventing it from occluding the airway and keeping airflow open. It’s inserted by sliding it along the roof of the mouth and then rotating it so the curved portion lies behind the tongue with the flange resting at the lips. This device is specifically for patients who are unconscious or have a diminished gag reflex; it’s not used in conscious patients due to gagging risk. Alternatives like a nasal cannula or nasal airway don’t reliably prevent tongue-induced obstruction, and a bag-valve mask is a ventilation tool rather than a patency-maintaining adjunct.