What patient population is contraindicated for using an oropharyngeal airway (OPA)?

The use of an oropharyngeal airway (OPA) is specifically contraindicated in patients who have a gag reflex or in those who are conscious because these conditions increase the risk of gagging or vomiting when an OPA is inserted. When a patient is conscious, their protective airway reflexes, including the gag reflex, are intact, which means they may react negatively to the presence of the airway. This can potentially lead to aspiration or airway obstruction if vomiting occurs as a response to the OPA.

In contrast, the OPA is designed for use in unconscious patients who lack a gag reflex since they cannot effectively protect their airway. The presence of facial injuries, while concerning, is not an absolute contraindication for OPA use; however, the airway must be assessed carefully to avoid exacerbating any injuries. Intubated patients do not require an OPA as they already have an airway secured through intubation.

Therefore, for safety and effectiveness, the OPA should only be used in scenarios where the patient is unconscious and without protective reflexes, making patients with a gag reflex or those who are conscious unsuitable candidates for this airway adjunct.