Nasopharyngeal airway

Reviewed and revised 7 February 2017

OVERVIEW

  • Nasopharyngeal airway (NPA) or nasal trumpet

USE

  • Can provide an airway in patients with an intact gag reflex, trismus or oral trauma
  • Facilitate suctioning in patients with a weak cough

DESCRIPTION

  • Soft, flexible anatomically designed airway adjunct
  • Sized by measuring from the tip of the patient’s nose to the earlobe
  • described by internal diameter in mm (range from 2–9 mm in half sizes)
  • commonly 6–7 mm in an adult female and 7–8 mm for an adult male

Parts

  • smooth angled tip
  • curved body
  • flanged end

Sizes

Size
(Fr)
Internal diameter
(mm)
External diameter
(mm)
2468.1
2879.4
32810.8

METHOD OF INSERTION/ USE

  • pre-prepare nose with topical local anaesthetic/vasoconstrictor spray
  • Apply lubricant then insert tube with bevel facing the nasal septum
  • advance along the septum horizontally, following the natural curvature of the floor of the nasopharyngeal cavity and rotated 90 degrees to lie in the nasopharynx
  • a safety pin can be placed just behind the flange to prevent it advancing too far
  • The tip should lie behind the uvula

COMPLICATIONS

  • epistaxis and aspiration
  • ulceration
  • insertion through the cribriform plate into the brain
  • may still stimulate gag reflex and vomiting
  • sinusitis

OTHER INFORMATION

Contraindications:

  •  base of skull or nasal fractures
  • coagulopathy
https://vimeo.com/56656863

Introduction to ICU Series

  • Roberts K, Whalley H, Bleetman A. The nasopharyngeal airway: dispelling myths and establishing the facts. Emerg Med J. 2005 Jun;22(6):394-6. PMC1726817.
CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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