What is the proper use of airway adjuncts in the field?

• A. Use oropharyngeal for unconscious; nasopharyngeal with caution; (correct)
• B. Never use airway adjuncts
• C. Use only if patient requests
• D. Use nasopharyngeal for all

Answer: (A)

Airway adjuncts are tools to keep the airway open by preventing the tongue from occluding the pharynx, and the choice depends on how alert the patient is and whether there are potential injuries.

An oropharyngeal airway is appropriate in someone who is unconscious and does not have a gag reflex. It sits in the mouth and shoves the tongue forward, reducing obstruction and making ventilation easier without provoking a gag. In a patient who still has a gag reflex or who is semi-conscious, this device can trigger gagging or vomiting, so it isn’t the preferred option.

A nasopharyngeal airway goes through the nose into the pharynx and can be better tolerated in many semi-conscious patients or when nasal access is advantageous. However, it carries risks and is used with caution: avoid if there’s suspected basal skull fracture or significant facial trauma, and ensure lubrication and gentle insertion to minimize nasal or intracranial injury.

So, in the field, the proper approach is to use an oropharyngeal airway for an unconscious patient, and use a nasopharyngeal airway with caution in appropriate patients.