Date Published

June 17, 2013

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: With respect to use of an OPA, I have had discussions with coworkers who always will insert one with an unconscious patient. Is this proper? My argument is, even the MOH literature seems to state that 'less invasive' airway management such as positioning, suctioning and constant monitoring of the airway is acceptable. Some common situations of this would be a post-itcal or alcohol intoxication persons. Thanks.


 The concern with an OPA is that a patient may have an impaired level of consciousness however still have an intact gag reflex. Automatically utilizing an OPA €“ especially for post ictal or alcohol intoxication- may lead to the complications from an OPA such as vomiting, aspiration, and/or laryngospasm.

As the use of the OPA is not a controlled act, we promote adherence to the Basic Life Support Patient Care Standards (BL-PCS) for the use of such airway adjuncts. Great question!



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