This all depends on the size of the nares and how much the tongue is obstucting. If you still can not effectively ventilate through the NPA due to a very small size inserted, the OPA would hopefully be an option. One may start with an NPA to suffice in a patient with a present gag but as they become more unconscious, the OPA might be your better option. The NPA is also an excellent way to clear some secretions from the back of the throat and lungs with a suction catheter. One could have the OPA to maintain an airway for use with the BVM and the NPA for secretion removal.
