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Nasopharyngeal AirwayAka: Nasal Airway

Indications
1. Airway maintenance
  1. Oral Airway placement difficult
  2. Semiconscious patient not tolerating Oral Airway
2. Nasotracheal intubation guide in maxillofacial trauma
Complications
1. Esophageal intubation (if too long)
2. Laryngospasm
3. Vomiting (less likely than with Oral Airway)
4. Nasal mucosa injury and secondary blood aspiration
Sizing
1. General
  1. Airway diameter should not be too large
    1. Should not blanche the nasal ala
  2. Length: Tip of the nose to the tragus of the ear
2. Adult
  1. Large: 8-9 mm Internal Diameter (I.D.)
  2. Medium 7-8 mm Internal Diameter (I.D.)
  3. Small 6-7 mm Internal Diameter (I.D.)
3. Child
  1. Diameters: 12F (~3mm ET Tube) to 36F
  2. Alternatively may use a shortened ET Tube
    1. ET Tube 3 mm will fit a term newborn's NP airway
Technique
1. Lubricate with water soluble lubricant
  1. or anesthetic jelly
2. Gently insert into nostril
  1. Along floor of nostril, perpendicular to face
  2. If resistance occurs
    1. Try slight tube rotation
    2. Try other nostril
3. Check for respirations following placement
Maintenance
1. Check patency frequently
2. Tube may be blocked by mucus, blood, secretions

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.