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A nasopharyngeal airway is a short tube which is designed to be inserted through the nose to secure the airway of a patient who requires medical attention. This type of airway is often seen in emergency response, when people want to make sure that the patient's airway remains clear during the treatment and transport. It can be used safely on unconscious patients, and can also provide access for suction, both in the field and in hospital environments. Using a nasopharyngeal airway is not the same thing as nasotracheal intubation, in which a tube is passed through the nose and into the trachea to stabilize a patient's airway.
The design of a nasopharyngeal airway is fairly simple. The tube is short and flexible, designed to be inserted with the assistance of a lubricant which will prevent it from snagging on any of the delicate tissues in the nose. A flared base prevents the airway from vanishing into the nose. This flared base is referenced in the alternate name for a nasopharyngeal airway: nasal trumpet. With a nasopharyngeal airway in place, the patient's tongue cannot drop back and occlude his or her airway, keeping it clear so that the patient can breathe.
Gagging with this type of airway is usually minimal, in contrast with an oropharyngeal airway, another type of emergency airway which is inserted through the mouth. An airway inserted through the mouth is usually not tolerated very well by patients who are conscious, because it is uncomfortable and it can trigger the gag reflex. However, gagging can occur with a nasopharyngeal airway; if the tube is slightly too long, the patient may gag when it is placed, which requires repositioning or the insertion of a shorter tube.
Using a nasopharyngeal airway is contraindicated in some situations. With some types of skull fracture, for example, this airway can be dangerous. With basal skull fractures, a nasopharyngeal airway could come into contact with brain tissue, which is highly undesirable. The device is also not recommended in patients who have serious facial injuries.
The nasopharyngeal airway can be found in the tool kits of many emergency responders, because it can be used quickly on a scene to secure the patient's airway. This is important, as a patient's condition can rapidly decline if his or her airway becomes blocked. Being proactive about airway management can reduce the patient's risk of brain damage and other complications, and can contribute to a better prognosis for the patient.
@Monika - I have a friend who works as a first responder. She inserts these types of airways pretty often and she says she prefers for the patient to be conscious.
Although it is a little bit easier to insert the airway on an unconscious patient, if the patient is conscious you can quickly tell if you inserted it wrong! Not that my friend is in the habit of inserting airways wrong of course, but it makes her feel more secure.
When I was just out of high school I had a friend who was an EMT. I remember her telling me that the first time she had to insert one of these things she was terrified. Even though she was supervised she was still afraid something would go wrong!
All went well though, and she was able to use the nasopharyngeal airway to keep her patients airway clear until they got her to the hospital.
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