Nasopharyngeal Airway

Q: what's the Nasopharyngeal Airway?

A: A nasopharyngeal airway device (NPA) is a hollow plastic or soft rubber tubes that a healthcare provider can utilize to          assist with patient oxygenation and ventilation in patients who are difficult to oxygenate or ventilate via bag mask                ventilation.

   For example. NPAs are passed into the nose and through to the posterior pharynx. NPAs do not cause patients to gag and    are, therefore, the best airway adjunct in an awake patient and a better choice in a semiconscious patient that may not        tolerate an oropharyngeal airway due to the gag reflex.

Q: How to use it?

A: 1.Preparation for insertion of an NPA involves 2 steps. First, the healthcare provider obtains the correct size NPA, and              second, the provider coats the NPA with lubricant, anesthetic jelly, or any water-soluble lubricant.

    2.Insertion of an NPA involves the healthcare provider inserting the NPA into the nares with the concave side facing                down to allow for insertion into the posterior pharynx behind the tongue. If there is resistance, the NPA can be rotated,        which should allow the tube to fit snugly into the nares. Do not aim the NPA cephalad, but instead aim it straight back          toward the occiput and along the nasal floor via the lower pathway of the naris.

    3.In blind NT intubation, the healthcare provider begins by placing the tube into the chosen naris similar to the NPA with         the concave side facing down and aiming toward the occiput. The bevel of the tube should face the lateral wall of the           nasal passage and the tube should be slowly advanced toward the occiput and nasopharynx. At approximately 6 to 7           cm in the tube will pass through the nasal passageway and begin its acute drop into the nasopharynx. At that point,             the provider should feel significantly less resistance and the patient, if awake, will be very uncomfortable, as                       passing the tube into the nasopharynx is the most painful part of the procedure. Resistance should be                                 overcome with gentle, slowly rotating and twisting motions until the tube passes through.

Q:When or who should to use it?

A: Spontaneously breathing patients with soft tissue obstruction of the upper airway.

    Sometimes for dilation and anesthesia of the nasal passage to prepare for nasotracheal intubation.