Nasopharyngeal Airway (NPA)

Airway · Emergency · 10–20 min

Soft rubber airway inserted through the nostril; tolerated by semi-conscious patients.

Indications

  • • Semi-conscious with airway obstruction
  • • Trismus
  • • Facial injury (relative)

Contraindications

  • ⚠ Suspected basal skull fracture
  • ⚠ Severe coagulopathy
  • ⚠ Nasal obstruction/fracture

Equipment

  • • NPA sized nostril to tragus
  • • Lubricant
  • • Suction

Positioning

  • • As appropriate for the procedure and patient comfort.

Consent

  • • Explain indication, benefits, alternatives
  • • Explain risks & complications
  • • Obtain written/verbal consent as per SOP
  • • Document consent

Universal precautions

  • • Hand hygiene
  • • PPE — gloves, mask, eye protection
  • • Aseptic technique
  • • Sharps safety
  • • Verify patient identity & site

Step-by-step (0/4)

Tap to complete

Tip of nose to tragus; diameter ~little finger.

Immediate complications

  • ⚠ Epistaxis
  • ⚠ Trauma
  • ⚠ Intracranial insertion (basal skull #)

Recognition

  • • Bleeding
  • • CSF rhinorrhea

Initial management

  • • Remove; pressure

Prevention

  • • Screen for basal skull #
  • • Lubricate

Post-procedure observation

  • • Vitals q15min × 1h then hourly

Monitoring

  • • Site inspection
  • • Symptom review

Documentation

  • • Procedure note
  • • Consent
  • • Findings

Patient instructions

  • • Report pain, bleeding, fever, worsening symptoms

Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.

WardRound

WardRound

Clinical Decisions in Seconds