Videos

Nasopharyngeal airway animated demonstration

How to select the correct size naspharyngeal airway and insert the airway device safely.

Equipment needed

  • Personal protective equipment, including gloves

  • Bag-valve-mask apparatus

  • Oxygen

  • Reservoir bag attached to the bag-valve-mask apparatus

  • Suction

  • Nasopharyngeal airway

  • Resuscitation kit.

Contraindications

Do not use a nasopharyngeal airway if there is suspicion of a basal skull fracture. This is because of the rare possibility of insertion of the nasopharyngeal tube through a basal skull fracture, penetrating into the cranial vault.

Complete upper airway obstruction is an absolute contraindication for bag-valve-mask ventilation.

Indications

  • Respiratory failure

  • Failed intubation.

A nasopharyngeal airway is a good choice of simple adjunct when the patient is too alert to tolerate an oropharyngeal airway, but requires help to maintain an open airway. It can also be used if an oropharyngeal airway is contraindicated for other reasons such as oral airway obstruction secondary to a foreign body.

Complications

  • Nasal trauma

  • Penetration of the cranial vault in the setting of a basal skull fracture.

Aftercare

Look, listen, and feel to check for patency of the airway and adequate ventilation. Simple airway manoeuvres may still be required.

Continue to resuscitate the patient in keeping with life support guidelines, using ABCDE principles.

If the patient continues to require resuscitation, replace the nasopharyngeal airway and mask ventilation with a definitive airway and ventilation. An advanced airway enables chest compressions to be delivered continuously without pausing during ventilation. Most patients with return of spontaneous circulation remain comatose and will need tracheal intubation and mechanical ventilation.[186]​​