Nasopharyngeal airway

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In medicine, a nasopharyngeal airway, also known as an NPA or a nasal trumpet because of its flared end, a type of airway adjunct, is a tube that is designed to be inserted into the nasal passageway to secure an open airway. When a patient becomes unconscious, the muscles in the jaw commonly relax and can allow the tongue to slide back and obstruct the airway. The purpose of the flared end is to prevent the device from becoming lost inside the patient's head. A safety pin is often included in the NPA kit to be attached to the outside for just such a purpose.

Indications and contraindications

Nasopharygeal airways are sometimes used by people who have sleep apnea.

These devices are also used by emergency care professionals such as EMT'S and paramedics in situations where an artificial form of airway maintenance is necessary but it is impossible or unadvisory to use an oropharyngeal airway, the preferred type of airway adjunct. For example, in a patient having epileptic seizures whose teeth are clenched shut. In an unconscious patient, suction of the upper airways may also be applied via an NPA.

Insertion of an NPA is contraindicated in patients with severe head or facial injuries, or have evidence of a basal skull fracture (Battle's sign) due to the possibility of direct intrusion upon brain tissue. An oropharyngeal airway may be used instead, but these devices frequently trigger a patient's gag reflex, while nasopharyngeal airways often do not.[1]

Insertion

The correct size airway is chosen by measuring the device on the patient: the device should reach from the patient's nostril to the earlobe or the angle of the jaw.[1] The outside of the tube is lubricated with a water-based lubricant so that it enters the nose more easily. The device is inserted until the flared end rests against the nostril.

Reference

  1. 1.0 1.1 Daniel Limmer and Michael F. O'Keefe. 2005. Emergency Care 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 147.

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