TL;DR

OPA and NPA Airways: Oropharyngeal (unconscious, no gag) and nasopharyngeal (semi-conscious) adjunct airways.

By Valenke Exam Prep Team·Last updated 2026-06-02

OPA and NPA Airways

Definition

Oropharyngeal (unconscious, no gag) and nasopharyngeal (semi-conscious) adjunct airways.

Regulatory Context

Regulatory context for opa and npa airways includes federal and state requirements. Healthcare facilities must comply with CMS Conditions of Participation, state licensure requirements, and accreditation standards (Joint Commission or AAAHC). Non-compliance can result in citations, fines, or loss of Medicare/Medicaid reimbursement.

Patient Communication

Communication about opa and npa airways in the prehospital setting includes: explaining procedures to the patient in simple terms, obtaining informed consent when possible (implied consent for unresponsive patients), providing a calm and reassuring presence, and delivering a structured handoff report (SBAR: Situation, Background, Assessment, Recommendation) to the receiving facility.

Workplace Applications

In daily practice, opa and npa airways is applied consistently according to facility protocols and current evidence-based guidelines. Competency is maintained through annual skills validation, continuing education, and quality improvement participation.

Equipment & Tools

Equipment used in opa and npa airways assessment and treatment:

King airway: Supraglottic blind-insertion airway device. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
BVM: Bag-valve-mask for manual ventilation. Available sizes: Adult (1500mL), Pediatric (500mL), Infant (250mL)
Pulse oximeter: Measures SpO2 via infrared absorption through capillary bed. Available sizes: Finger clip, Earlobe, Pediatric wrap
Waveform capnograph: Measures end-tidal CO2 continuously with waveform display. Available sizes: Mainstream (inline), Sidestream (sampling)

Documentation

Documentation of opa and npa airways in the patient care report (PCR) must include: time of assessment, findings, interventions performed, patient response, and reassessment findings. Use objective, measurable terms like "patient reports 8/10 chest pain" rather than "patient in pain." Document pertinent negatives. All medications administered must include drug name, dose, route, time, and patient response.

Why It Matters

Sizing, insertion, and contraindications tested on EMT exam.

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Frequently Asked Questions

What medications are commonly associated with opa and npa airways?▼

For opa and npa airways: amiodarone: 300mg IV/IO first dose, 150mg second dose, route IV/IO, for Refractory VF/pVT. epinephrine: 1:10,000 1mg IV/IO q3-5min (cardiac arrest), 1:1,000 0.3mg IM (anaphylaxis), route IV/IO, IM, ET, for Cardiac arrest, anaphylaxis, severe asthma.

What assessment tools help evaluate opa and npa airways?▼

For opa and npa airways: Cincinnati Stroke Scale: evaluates Facial droop, Arm drift, Speech abnormality; scoring is Any 1 positive = 72% probability of stroke. SAMPLE: evaluates Signs/symptoms, Allergies, Medications, Past history, Last intake, Events; scoring is Mnemonic for patient history gathering.

What equipment is needed for managing opa and npa airways in the field?▼

For opa and npa airways: Waveform capnograph provides Measures end-tidal CO2 continuously with waveform display. BVM provides Bag-valve-mask for manual ventilation. King airway provides Supraglottic blind-insertion airway device.