Which is a contraindication to using an extraglottic airway device?

• A. Gag reflex
• B. Unsuccessful ventilation
• C. Hypoxia
• D. Respiratory arrest

Answer: (A)

An intact gag reflex makes an extraglottic airway contraindicated because the patient is likely conscious and able to protect the airway. Inserting the device in this situation can provoke gagging and coughing, increase the risk of vomiting, and may lead to aspiration or a poor seal, defeating the purpose of securing the airway. The other scenarios described—ventilation still being unsuccessful, hypoxia, or respiratory arrest—do not by themselves prevent use of an extraglottic device; in fact, these are common reasons to use it as a temporary measure or bridge to a definitive airway when needed.