How to insert an oral or nasal airway
Other platforms explain it with text and video. In VMS you practice it on the patient.
Airway adjuncts keep the tongue off the back of the throat.
Step by step
Oral airway size
Corner of the mouth to the angle of the jaw. [1]
Oral insertion
Upside down along the palate and rotate 180 degrees, or straight in with a tongue depressor. Only without a gag reflex. [1]
Nasal airway size
Nostril to earlobe; diameter like the nostril. [1]
Nasal insertion
Lubricate, bevel toward the septum, gentle rotation; tolerated with a gag reflex. [1]
Avoid nasal
With suspected skull base fracture or major facial trauma. [1]
Check
Breathing or ventilation improves. [1]
Common errors
- Oral airway with a gag reflex.
- Wrong size.
- Forcing a nasal airway.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). VMS is not affiliated with these organizations. Updated: 2026-10-11.