A patient is unresponsive and you hear snoring respirations with gag reflex upon attempting airway insertion. What should you do?

In this scenario, the presence of snoring respirations indicates that the airway may be partially obstructed, often due to the tongue falling back or other anatomical structures compromising airflow. The gag reflex indicates that the patient has some level of response, suggesting that their airway may not be completely compromised, but the airway needs to be maintained.

A nasopharyngeal airway is an appropriate intervention in such a case as it can help establish and maintain an airway while minimizing further stimulation of the gag reflex, which could be triggered by other airway adjuncts. The nasopharyngeal airway can be inserted through the nose and extends into the nasopharynx, which provides a clear conduit for air without risking stimulation of the gag reflex too much.

Other options, like using an oropharyngeal airway, may not be suitable because they can trigger the gag reflex in patients who exhibit any level of responsiveness. The choice of technique should always prioritize maintaining the airway while reducing the risk of further complications, particularly in a patient who is unresponsive but still has some protective reflexes.