Because an oropharyngeal airway can mechanically stimulate the gag reflex, it should only be used in a deeply sedated or unresponsive patient to avoid vomiting and aspiration .[24] Careful attention must be made while inserting an OPA. The user must avoid pushing the tongue further down the patient's throat. This is usually done by inserting the OPA with its curve facing cephalad and rotating it 180 degrees as you enter the posterior pharynx.[16]