Nasopharyngeal airway

Nasopharyngeal Airway

Nasopharyngeal airway

A nasopharyngeal airway (NPA), also known as a nasal trumpet, is a type of airway management device used to maintain an open airway. It is inserted into the nasal passage to ensure that the airway remains open, especially in patients who are unconscious or have a compromised airway.

Design and Function

The nasopharyngeal airway is typically made of soft, flexible material such as rubber or silicone. It is designed to be inserted through the nostril and extend into the nasopharynx, the upper part of the throat behind the nose. The device is often flared at the end to prevent it from slipping into the nasal cavity.

The primary function of the nasopharyngeal airway is to bypass obstructions in the oropharynx and provide a clear path for air to reach the lungs. It is particularly useful in situations where the oropharyngeal airway is not suitable, such as in patients with a strong gag reflex.

Indications

The nasopharyngeal airway is indicated in several situations, including:

• Patients with a decreased level of consciousness who are at risk of airway obstruction.
• Patients with trismus or jaw injuries that prevent the use of an oropharyngeal airway.
• Situations where endotracheal intubation is not immediately possible.

Contraindications

While the nasopharyngeal airway is a versatile tool, it is contraindicated in certain conditions:

• Patients with basilar skull fractures, as the insertion of the device could potentially penetrate the cranial cavity.
• Patients with severe nasal trauma or epistaxis (nosebleeds).

Insertion Technique

The insertion of a nasopharyngeal airway involves the following steps:

1. Select the appropriate size of the airway by measuring from the patient's nostril to the earlobe. 2. Lubricate the airway with a water-soluble lubricant to facilitate smooth insertion. 3. Insert the airway into the nostril, with the bevel facing the septum, and gently advance it along the floor of the nasal passage. 4. Continue insertion until the flange rests against the nostril.

Complications

Complications associated with the use of a nasopharyngeal airway include:

• Nasal bleeding due to trauma during insertion.
• Gagging or coughing if the airway is too long and irritates the pharynx.
• Infection if the device is not properly sterilized.

Advantages

The nasopharyngeal airway offers several advantages:

• It can be used in both conscious and unconscious patients.
• It is less likely to induce a gag reflex compared to an oropharyngeal airway.
• It is relatively easy to insert and does not require specialized equipment.

Related Pages

• Airway management
• Oropharyngeal airway
• Endotracheal intubation

U.S. Army Spc. Joseph McMaster receives a nasopharyngeal airway tube

See Also

• Tracheostomy
• Laryngeal mask airway