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

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.