Which is the best way to manage a casualty's airway if the casualty is unconscious?

In managing an unconscious casualty's airway, one of the most critical aspects is to ensure that the airway is clear and remains unobstructed, especially if the casualty is breathing on their own. Inserting a nasopharyngeal airway (NPA) is an effective technique in this scenario because it helps to maintain an open airway by preventing the tongue from falling back and blocking the throat. This is particularly important in unconscious individuals who have a decreased gag reflex, making them more susceptible to airway obstruction.

Using an NPA is usually preferable when the casualty has intact respiratory drive because it allows for the spontaneous breathing to continue without interruption, therefore facilitating adequate oxygenation. The use of an NPA is often indicated when the patient has a decreased level of consciousness but is still capable of breathing independently.

The other options presented lack the same immediacy or appropriateness given the context of an unconscious casualty who is still breathing: performing CPR is reserved for cases where there is no pulse or breathing; monitoring pulse and breathing alone may not provide proactive airway management; and administering supplemental oxygen does not address the critical need to secure the airway first. Hence, inserting an NPA is the best practice in ensuring that the airway remains open and functional in an unconscious but breathing casualty