Which airway is indicated for an unresponsive casualty without gag reflex?

• A. Oropharyngeal Airway
• B. Nasopharyngeal Airway
• C. Endotracheal Tube
• D. Laryngeal Mask Airway

Answer: (A)

When someone is unconscious and lacks a gag reflex, the priority is keeping the airway open. An oropharyngeal airway accomplishes this by holding the tongue away from the back of the throat, preventing obstruction and allowing ventilation or easier bag-valve-mask support. It’s designed for use in unresponsive patients who do not have a gag reflex, so it can be inserted quickly without triggering gagging.

Inserting it correctly involves sliding the device in with the tip toward the hard palate (often inserted upside down) and then rotating it as it passes the tongue so the curved portion sits in the pharynx and the flange rests at the lips. This bypasses the tongue’s tendency to fall back and block the airway.

The other options aren’t as appropriate here: a nasopharyngeal airway is more suitable when there might be a gag reflex or nasal/Basal skull concerns and is more challenging to place in an already unresponsive patient who lacks gag reflex; an endotracheal tube or laryngeal mask airway are advanced airways that require more training and equipment and are not the first-line choice in this scenario. The key idea is using a simple airway adjunct that safely maintains patency in an unconscious patient without gag reflex.