When should you not use an oropharyngeal airway?

• A. When the patient has a gag reflex.
• B. When the patient is unconscious and has no gag reflex.
• C. In patients with facial trauma.
• D. In patients with an oral injury.

Answer: (A)

An oropharyngeal airway is used to prevent the tongue from occluding the airway in someone who cannot protect it. You should not use it in a patient who still has a gag reflex because inserting the device will trigger gagging, which can lead to vomiting and aspiration, worsening airway protection. In contrast, it’s appropriate for an unconscious patient who has no gag reflex, since they cannot protect their airway on their own. The other scenarios describe situations where airway management becomes more complex and an OPA may be avoided or replaced with other methods, but the primary contraindication is the presence of a gag reflex.