• Nasopharyngeal airways provide a conduit for
airflow between the nares and the pharynx.
• Nasopharyngeal airways prevent mandibular tissue from obstructing
the posterior pharynx.
• Nasopharyngeal airways may be used in conscious patients (unlike
• Nasopharyngeal airways may be used in children with impaired
consciousness or in neurologically impaired patients with poor pharyngeal
tone leading to upper airway obstruction.
• Nasopharyngeal airways can be used to suction secretions.
• Nasal airway occlusions.
• Nasal fractures.
• Coagulopathy (because of the risk of epistaxis).
• Cerebrospinal fluid leak.
• Basilar skull fracture.
• Adenoidal hypertrophy.
• A nasopharyngeal airway is a soft rubber or plastic
• Nasopharyngeal airways come in various sizes ranging from 12F
• A shortened tracheal tube may be used as a nasopharyngeal airway.
• Lubrication jelly.
• The tube is lubricated and inserted into the
nostril and positioned into the posterior pharynx.
• Advance the tube gently, following the natural curvature of the
nasal passage to direct the tube in a posterior inferior position.
• After measuring as above, use the largest diameter tube that
can fit into the nose without causing blanching of the nares.
• If passage does not occur easily, attempt the other nostril because
patients may have different size nasal passages.
• Figure 3–1 shows a nasopharyngeal
airway in place (sagittal view).
Sagittal view of nasopharyngeal airway in place.
• Because the nasopharyngeal airway has a small
internal diameter, it can be obstructed with mucus, blood, vomit, or
the soft tissues of the pharynx.
• When necessary, suction the airway frequently to ensure patency.
• Use pulse oximetry to measure oxygen saturation levels.
• Measure heart rate.
• Check blood pressure using a noninvasive device.
• If the nasopharyngeal airway is too long, it
may cause bradycardia through vagal stimulation or it may injure
the epiglottis or vocal cords.
• Physical irritation of the larynx or lower pharynx may stimulate
coughing, vomiting, or laryngospasm (if the tube is too long).
• Nasopharyngeal airways can cause a pressor response with increased
• Failure of insertion.
• Epistaxis (due to mucosal tears or avulsion of turbinates).
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