Why Choose an NPA
The nasopharyngeal airway is tolerated by patients with an intact gag reflex, which makes it useful for those with altered mental status, seizure aftermath, or clenched jaws. It is often the preferred adjunct for semiconscious patients.
Sizing and Technique
Measure from the tip of the nose to the earlobe, and choose a diameter approximately the size of the patient's little finger or nostril. Lubricate the tube with a water-soluble lubricant and insert it with the bevel toward the septum, advancing gently along the floor of the nose. Never force the tube, and try the other nostril if resistance is met.
Cautions
Use caution in patients with suspected facial fractures or basilar skull fracture because of the theoretical risk of entering the cranial vault. Most modern guidance recognizes that the risk is very low, but the NREMT may still test caution. Always be ready to suction and to support ventilation with a BVM.