When inserting an oropharyngeal airway in an adult, you should insert it using the fishhook technique and rotate 180 degrees during insertion.

• A. Insert with a fishhook and rotate 180 degrees during insertion
• B. Insert straight in without rotation
• C. Push with the curve facing the tongue
• D. Insert on the left side first

Answer: (A)

The main idea is to position the airway so the tongue doesn’t occlude the airway in an unconscious patient and to seat the device safely in the oropharynx. In adults, the fishhook technique is used: insert the airway upside down with the tip toward the hard palate, then rotate 180 degrees as it passes the soft palate so the bevel faces the tongue and the curve sits in the throat. This orientation helps keep the airway open, reduces trauma to the mouth and teeth, and ensures the device sits midline rather than pressing awkwardly against tissues. Inserting straight in without rotation can push the airway incorrectly or cause trauma, and other orientations can misalign the device or injure tissues.