The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA). Examples of when a NPA should be considered. Contraindications and considerations for nasal airway insertion. Measuring a nasal airway for appropriate length and diameter. Insertion of a nasopharyngeal airway. Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Connect with me: Website:  https://passacls.com @PassACLS on X (formally known as Twitter) @Pass-ACLS-Podcast on LinkedIn Give back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated. Good luck with your ACLS class!