PROCEDURE FOR INSERTING THE NASOPHARYNGEAL AIRWAY
a. Determine the Need for the Nasopharyngeal Airway. Before you insert the
nasopharyngeal airway (NPA), you must assess the patient. This assessment should
include checking for signs of facial trauma; this is a contraindication for the use of the
nasopharyngeal airway. The assessment should also include determination of the
casualty's mental status. Any casualty with an altered mental status should have their
airway protected with a nasopharyngeal airway. Use the following indications and
contraindications to help with determining the need for the nasopharyngeal airway.
Casualty is conscious, semi-conscious or has an active gag reflex.
(b) Casualty has injuries to mouth (for example, broken teeth, massive
oral tissue damage).
Seizure casualties who may have clenched teeth due to active
(d) When vomiting is likely to occur.
(a) Any evidence of a head injury or roof of mouth (cribriform) fracture;
the airway may inadvertently enter the cranial vault with this type fracture.
(b) Exposed brain matter.
Cerebrospinal fluid (CSF) draining from nose, mouth, or ears.
b. Determine the Proper Size Nasopharyngeal Airway.
(1) Diameter: Select an airway with a diameter smaller than the casualty's
nostril or one that is approximately the diameter of the casualty's little finger.
Length: Measure from the tip of the patient's nose to their ear lobe