How to use a nasopharyngeal airway (NPA)
What is an NPA?
- A flexible rubber tube which goes through the nose ends at base of tongue (an adjunct to help keep airway open)
- An oxygen mask or bag mask ventilation can be applied over the top if needed
- Use: prevents tongue covering epiglottis in patients with reduced GCS. It is tolerated better than oropharyngeal airways in more alert patients.
- Size: Average height females require a size 6 NPA and average height males a size 7 NPA (Portex
sizing)
- Sizing using the patient’s finger as a guide is no longer recommended.
How to insert an NPA
- Lubricate the nasopharyngeal airway with water-soluble jelly
- Insert into the nostril (preferably right) vertically along the floor of the nose with a slight twisting action
- Aim towards the back of the opposite eyeball
- Confirm airway patency
- Click here for more details on NPAs
Video on NPA insertion
Sizes of NPA
Nasopharyngeal airways (NPAs). The addition of safety-pins to the flanged end prevents them being lost into the oropharynx.
Other airway pages
How to use an oropharyngeal airway
How to use a supraglottic airway
What is an endotracheal tube (ETT?)
What is a tracheostomy?
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What is the length of nasopharynx?
How big is the nasopharynx? The size of your nasopharynx varies among people. It's about 2 centimeters in diameter and 4 centimeters long.
Why is it important to choose the correct size when using an oropharyngeal or nasopharyngeal airway?
When using a nasopharyngeal airway, selecting the proper size is also important. If the NPA is too long, it will either enter the larynx and irritate the coughing and gag reflexes, or be inserted into the vallecula, possibly causing an airway obstruction.
What are the sizes of airway?
Adult sizes are the #8 (8 cm), #9 (9 cm), #10 (10 cm), and #11 (11 cm), designated according to the height measured horizontally from the flanges to the distal end of the airway.