What is the main difference between an oropharyngeal airway and a nasopharyngeal airway?

As the name implies, an oropharyngeal airway is placed in the mouth and a nasopharyngeal airway is inserted through the nose. The distal end stops at the level of the pharynx.

When do you insert the NPA?

NASOPHARYNGEAL AIRWAY (NPA) Unlike the oral airway, NPAs may be used in conscious or semiconscious individuals (individuals with intact cough and gag reflex). The NPA is indicated when insertion of an OPA is technically difficult or dangerous. NPA placement can be facilitated by the use of a lubricant.

What is a NPA used for?

A nasopharyngeal airway device (NPA) is a hollow plastic or soft rubber tubes that a healthcare provider can utilize to assist with patient oxygenation and ventilation in patients who are difficult to oxygenate or ventilate via bag mask ventilation, for example.

Why would you use a nasopharyngeal airway?

The nasopharyngeal airway (NPA) is a (now) disposable soft tubular device designed to support the nasal route of breathing, controlling airway obstruction at the nasal cavities, nasopharynx, soft palate, and the base of the tongue.

What is the most serious potential complication of nasopharyngeal airway insertion?

Cribriform Insertion Cribriform insertion is perhaps the most catastrophic complication of a nasopharyngeal airway, but it is also the least likely. Improper technique can cause the tube to enter the cribriform plate, causing soft tissue or skull damage, and potentially even penetrating the brain.

When should an oropharyngeal airway be used?

Use an oropharyngeal airway only if the patient is unconscious or minimally responsive because it may stimulate gagging, which poses a risk of aspiration. Nasopharyngeal airways are preferred for obtunded patients with intact gag reflexes.

What nursing care does a patient with an oropharyngeal or nasopharyngeal airway require?

Be gentle when inserting either an oropharyngeal or nasopharyngeal airway. Avoid forcing an oropharyngeal airway, which can lead to trauma to the lips and tongue. Use caution when twisting the oropharyngeal 180 degrees to avoid trauma along the hard palate.

How do I know what size nasopharyngeal airway to get?

To determine the correct size, measure from the tip of your patient’s nose to the tip of their earlobe. In addition, choose an NPA which has a diameter a little smaller than the patient’s nares. The distal tip of the NPA is properly placed beyond the tongue base but should not be in contact with the epiglottis.

Do you insert nasopharyngeal airway during seizure?

Start by positioning the patient on their side, suction the oropharynx and insert a nasal airway to clear a path for oxygenation and ventilation. Do not place anything in a seizure patient’s mouth.

Can you use NPA on conscious patient?

Nasopharyngeal airways are also used to keep the airway open and can be used with patients who are conscious or semi-conscious. For example, semi-conscious patients may need an NPA because they are at risk for airway obstruction but cannot have an OPA placed due to an intact gag reflex.

How often should a nasopharyngeal airway be changed?

The nasopharyngeal airway may be inserted at the end of another procedure – for instance, corrective surgery to the midfacial area – or as a separate procedure at another stage. Long term nasopharyngeal airways are usually changed every four to six weeks or earlier if needed.

When is an oropharyngeal airway safe to use?

Advanced Airways. In a deeply unresponsive/unconscious patient, an oropharyngeal airway is safe to use because the gag reflex will be depressed. Another advantage of the nasopharyngeal airway is that it can be used in patients with mouth trauma, where an oropharyngeal airway cannot or should not be used.

Which is better the distal or oropharyngeal airway?

The distal end stops at the level of the pharynx. The nasopharyngeal airway has some advantages over an oropharyngeal airway, most notably it can be used in both conscious and unconscious patients (because the oropharyngeal airway can stimulate the gag reflex).

How is the oropharyngeal device placed in the pharynx?

When placing the oropharyngeal device, it is important not to press the tongue into the airway. Clinicians will either turn the curve of the device 180° or 90° respective to its final position before inserting it. Once the airway is advanced into the pharynx, the device can be rotated into place.

How is the nasopharyngeal airway sizing done?

Sizing the nasopharyngeal airway follows the same approach, with the exception that you align it with the nose instead of the mouth. When placing the oropharyngeal device, it is important not to press the tongue into the airway. Clinicians will either turn the curve of the device 180° or 90° respective to its final position before inserting it.