1.2 Primary Airway Adjuncts

What is the purpose of primary airway adjuncts?

To help maintain airway patency in unconscious patients, usually alongside correct positioning.

What are the two primary airway adjuncts used in BLS?

Oropharyngeal airway (OPA) and Nasopharyngeal airway (NPA).

What is the function of an OPA?

It holds the tongue off the epiglottis to maintain a clear airway via the mouth.

What is the function of an NPA?

It is inserted into the nostril to displace the tongue and soft tissue anteriorly, allowing airflow.

When is an OPA indicated?

To support airway patency in an unconscious patient without a gag reflex.

What are the contraindications for OPA use?

Trismus, Intact gag reflex, Traumatic or non-traumatic brain injuries with adequate ventilation.

What precaution must be taken when using an OPA?

Incorrect sizing or placement may worsen airway obstruction.

When is an NPA indicated?

To support airway patency in unconscious patients, especially when OPA is contraindicated.

What are the precautions for NPA use?

Facial or base of skull fractures, Traumatic/non-traumatic brain injuries, Risk of increased intracranial pressure.

What are signs of a base of skull fracture?

Raccoon eyes (periorbital bruising), CSF leaking from ears/nose, Battle’s sign (bruising behind the ears), Bleeding from ears.

Can an NPA be used if the patient has a gag reflex or trismus?

Yes, NPAs can be used in patients with a gag reflex, trismus, or oral trauma—unlike OPAs.

Why must OPAs and NPAs be used cautiously in brain injury patients?

They may trigger a gag reflex, increasing intracranial pressure and worsening the injury.

What is the first-line intervention before using an airway adjunct?

Positioning the patient to maintain airway patency.