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Nasopharyngeal Airway

Nasopharyngeal Airway

The nasopharyngeal airway (NPA) is a medical device that is inserted into the nose to provide an unobstructed airway during medical procedures and in the event of a medical emergency. It is also commonly referred to as a nasal trumpet.

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  • For nasal airway management only
Ref. No.: Size: Qty. Cs:
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NMR104701 3.5 100
NMR104702 4.0 100
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NMR104704 5.0 100
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NMR104706 6.0 100
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NMR104710 8.0 100
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NMR104712 9.0 100

Nasopharyngeal Airway For nasal

The nasopharyngeal airway (NPA) is a medical device that is inserted into the nose to provide an unobstructed airway during medical procedures and in the event of a medical emergency. It is also commonly referred to as a nasal trumpet.

What is a Nasopharyngeal Airway?

A nasopharyngeal airway (NPA) is a medical device that is inserted into the nose to keep the airway open. It is also called a nasal trumpet or nose hose. NPAs are used when patients cannot breathe on their own or when they are unable to protect their airway from aspiration.

How to use a Nasopharyngeal Airway

A nasopharyngeal airway (NPA) is a small, soft tube that is inserted through the nose into the throat. It is used when a person cannot breathe on their own or when they are having trouble clearing their airway. An NPA is also known as a nasal trumpet or nasotracheal tube.

NPAs are most often used in emergency situations, such as when a person is unconscious or having a seizure. They can also be used to help people with certain medical conditions, such as sleep apnea or heart failure, who cannot breathe on their own.

To insert an NPA, the healthcare provider will lubricate the tip of the tube and insert it into the person's nostril. The tube is then gently pushed until it reaches the back of the throat. Once in place, the healthcare provider will secure the tube with tape or a strap.

The NPA can be left in place for several hours or days, depending on the person's needs. Once the NPA is no longer needed, it will be removed by the healthcare provider.

Advantages and disadvantages of using a Nasopharyngeal Airway

There are both advantages and disadvantages to using a nasopharyngeal airway. Some of the advantages include that it is less likely to cause vomiting than an oropharyngeal airway, it is easier to insert, and it is less likely to trigger the gag reflex. Additionally, a nasopharyngeal airway can be used if the patient has a bleeding nose or if their teeth are in the way of inserting an oropharyngeal airway. However, some of the disadvantages include that it can cause epistaxis (nosebleed), it can cause mucosal tears, and it can stimulate the vagus nerve which can lead to bradycardia.

When to use a Nasopharyngeal Airway

If you are having trouble breathing through your nose, you may need to use a nasopharyngeal airway. This is a small, flexible tube that is inserted through the nose and into the back of the throat. It helps to keep the airway open so that you can breathe more easily.

There are a few different situations when you might need to use a nasopharyngeal airway. If you have a cold or allergies and your nose is congested, this can make it difficult to breathe. In some cases, your doctor may recommend using an airway to help you breathe more easily during sleep.

If you have had surgery on your nose or sinuses, you may also need to use an airway for a short period of time. This is because the surgery can cause swelling in the nasal passages, which can make it difficult to breathe.

If you have a head injury, stroke, or other condition that causes paralysis of the muscles in the throat, you may need to use an airway to help you breathe. This is because the muscles in the throat are responsible for keeping the airway open. If they are not working properly, it can be difficult to breathe.

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Nasopharyngeal Airway

Nasopharyngeal Airway Advanced airway management demands precision and skill, especially in vulnerable patients. When performed correctly, however, initiating nasopharyngeal airways is very safe—and much safer than the alternative of doing nothing. Many first responders are reluctant to initiate a nasopharyngeal airway, citing fears of complications. But this route can enable intubation in patients with an intact gag reflex. Proper training can promote greater confidence, so don’t let fear deter you from practicing this life-saving technique.

Aspiration

The risk of regurgitation may be higher with a nasopharyngeal airway. This raises the risk of aspiration, which is already a risk of all artificial airways. A nasopharyngeal airway may also trigger a nosebleed, further elevating the risk of aspiration, but careful monitoring of the patient can reduce this risk. If a patient begins actively vomiting or is bleeding from the airway, aggressive removal of potential contaminants can prevent aspiration or reduce the volume of aspirated fluid. Suction-assisted laryngoscopy and airway decontamination (SALAD) using the DuCanto CatheterⓇ is highly effective. When intubation activates the gag reflex, intracranial pressure may increase, potentially complicating or causing other injuries. And so first responders should be mindful that regurgitation and aspiration may indicate other injuries.

1. Airway Trauma 

Airway trauma is the most common complication of a nasopharyngeal airway. In most cases, the injuries are minor, causing small bruises or wounds. However, an open wound increases the risk of developing an infection, especially if the patient bleeds, vomits, or aspirates. Long-term use of a nasopharyngeal airway may cause ulcers, particularly if you use a tube that is too rigid or too large. Selecting the right tube and ensuring that you can see the airway prior to intubation greatly reduces the risk of serious injuries.

2. Sinusitis and Nasal Structure Damage 

A nasopharyngeal airway may trigger sinusitis, especially in patients with a history of sinus disease. Very rarely, improper insertion can cause significant damage to nasal or sinus structures. This may increase the risk of chronic sinusitis. For example, a deviated septum makes it easier for bacterial biofilms to form inside the nose and sinuses, increasing the risk of chronic sinus disease. First responders must intubate slowly, choosing appropriately sized tubing to mitigate the risk. Always wear gloves, and never reuse tubing, because doing so can introduce bacteria into the sinuses.

3. Cribriform Insertion

Cribriform insertion is perhaps the most catastrophic complication of a nasopharyngeal airway, but it is also the least likely. Improper technique can cause the tube to enter the cribriform plate, causing soft tissue or skull damage, and potentially even penetrating the brain. Avoiding nasopharyngeal airways in patients with basal skull fractures, visible head injuries, or suspected spinal cord injuries virtually eliminates this risk.

Strategies for Safe Insertion and Maintenance 

First responders should proceed with caution in patients with a history of airway injuries and should ask about a history of bleeding disorders. Carefully monitor the patient during the entire procedure, even if it initially seems that the airway placement occurred with no complications.