Nasopharyngeal Airway

Also known as trumpets, nasopharyngeal airways are inserted through one nostril to create an air passage between the nose and the nasopharynx. The NPA is preferred to the OPA in conscious patients because it is better tolerated and less likely to induce a gag reflex.

The length of the nasal airway can be estimated as the distance from the nares to the meatus of the ears and it is usually 2-4 cm longer than the oral airway. Any tube inserted through the nose should be well lubricated and advanced at an angle perpendicular to the face (remember: the floor of the nose is the roof of the mouth! ). Use a nostril that is unobstructed.

While nasopharyngeal airways are better tolerated than oropharyngeal airways in awake or lightly anesthetized patients, they are contraindicated in patients who are anticoagulated, patients with basilar skull fractures, patients with nasal infectios and deformities as well as in children (because of risk of epistaxis).

If the nasopharyngeal tube is visible in the posterior oropharynx, it may provide safe passage of an nasogastric tube (NG tube) in a patient with maxillofacial fractures.