Which airway adjunct is appropriate for an unresponsive patient with no gag reflex?

• A. Nasal airway
• B. Oropharyngeal airway
• C. Bag-valve mask
• D. Endotracheal tube

Answer: (B)

In an unresponsive patient who has no gag reflex, the tongue is a common source of airway obstruction. An oropharyngeal airway props the tongue forward and keeps the airway open, creating a clear passage for air and making bag-valve mask ventilation easier. It’s the simplest and most reliable basic adjunct in this situation, and it does not trigger a gag reflex because the patient has lost protective reflexes. It should not be used if there is a gag reflex or facial trauma that would make insertion unsafe.

The other options aren’t the best fit here. A nasal airway can irritate nasal tissues and is less suitable in an entirely unconscious patient or when facial trauma or skull fracture is a concern. A bag-valve mask is a ventilation device, not an airway adjunct that keeps the airway open on its own. An endotracheal tube provides a definitive airway but requires more advanced assessment, skills, and equipment and isn’t the initial choice in a patient who can be managed with a simple airway adjunct.