Page 189 - 2023 SMOG Digital

NASOPHARYNGEAL AIRWAY

CLINICAL INDICATIONS:
• Depressed mental status with need for airway augmentation to ensure patency / access.
RELATIVE CONTRAINDICATIONS:
• Patient at high-risk of aspiration and/or unable to protect airway
• Massive facial trauma, burns, or suspicion of basilar skull fracture (e.g., CSF otorrhea, Battle’s sign, raccoon
eyes, mechanism).
PROCEDURE:
• Position patient in the sniffing position.
• Select appropriate sized NP tube and lubricate with water-soluble jelly (can measure tube by placing
exterior (lipped) end next to nare and tip should reach to angle of mandible).
• Select most patent nare, orient open angle medially, and pass tube in a posterior – not superior – direction.
If resistance is met, attempt to corkscrew slightly or remove and attempt in other nare. If unsuccessful, try
the next smallest sized tube.
• Pass tube until lip of NP tube rests against nare.
• Bag patient with BVM / mask as needed.

Document procedure, results, and vital signs.

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