Which airway adjunct is used if the patient is breathing after opening the airway in MCI?

• A. Oxygen mask
• B. Nasopharyngeal airway (NPA)
• C. Endotracheal tube
• D. Oropharyngeal airway (OPA)

Answer: (D)

When a patient is unconscious after you’ve opened the airway and is still breathing on their own, the goal is to keep the airway open without delaying ventilation or resorting to invasive airway management. An oropharyngeal airway does exactly that: it sits in the mouth behind the tongue and prevents the tongue from collapsing back and occluding the airway. This maintains a patent airway quickly and with minimal effort, which is ideal in a mass casualty incident where time and resources are limited.

It’s a fast, noninvasive option that doesn’t require the patient to have a gag reflex, which is why it’s chosen when the patient is unconscious. If the patient regains protective reflexes or starts to gag, remove it to avoid vomiting or aspiration.

In contrast, an oxygen mask helps deliver oxygen but does not secure the airway. A nasopharyngeal airway can be used in some unconscious patients, but it’s more situational—affected by nasal injuries or facial trauma and sometimes slower to place. An endotracheal tube provides a definitive airway but is invasive, takes more time, and is unnecessary if the patient is breathing adequately.