The Nasopharyngeal Airway

A NPA can be used for patients whose mouths are difficult to open, such as during a seizure.

To size:

The internal diameter of the NPA tube is marked on the side of the tube. Use a 6 mm size for women and 7 mm for men.

To insert:

  • Lubricate the tube with gel
  • Insert into the nostril gently curved side down
  • Aim towards the occiput
  • Use a twisting motion if necessary
  • Change to a smaller airway if there is firm resistance

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NPA are unlikely to stimulate the oropharynx and are better tolerated in lightly unconscious patients.

NPA can cause nasal haemorrhage so always check the oropharynx post-insertion for blood.

Learning Bite

Base of skull fracture is a relative contraindication to NPA insertion. Avoid using NPAs if patients have obvious mid-face injury.