Differences in Nasopharyngeal Airway Use Between Adults and Elderly Patients

Nasopharyngeal airways (NPAs) play a great role in patients of all ages. Although both adults and elderly patients may require NPAs in scenarios, differences in physiology, disease prevention, and treatment needs result in significant variations in their use. Besides, elderly patients often come with some chronic conditions, which can make insertion more challenging. In this article, to know these differences can improve treatment effectiveness and reduce complications.

What is a Nasopharyngeal Airway?

A nasopharyngeal airway (NPA) is inserted into the nasal passage to maintain an open airway. It is commonly used in emergency care, anesthesia, and patients with respiratory impairment. PVC nasopharyngeal airways are one of the most popular choices because of their durability, biocompatibility, and prices. However, when choosing it, you should consider usage, patients' ages, conditions, and precautions, etc. 

Key Differences in NPA Use Between Adults and Elderly Patients

Physiological Differences and Tube Selection

Adults

Adults have wider nasal passages and thicker nasal mucosa, allowing for larger tube diameters. NPAs with a 28-32Fr diameter are recommended to ensure sufficient airflow. Since the adult nasal cavity is relatively firm, a lubricant should be applied to reduce friction during insertion.

Elderly Patients

Compared to younger adults, elderly patients have thinner nasal tissues and fragile blood vessels, making them prone to nasal bleeding or injury. A smaller diameter (24-28Fr) is recommended. Due to age-related soft tissue degeneration, gentle insertion is essential to prevent mucosal damage.

Respiratory Function and Indications

Adults

Suitable for mild airway obstruction, especially in semi-conscious patients who still have some breathing ability.

Commonly used in postoperative recovery, emergency care (e.g., trauma, alcohol intoxication, etc.).

Elderly Patients

More prone to hypoxemia due to reduced lung function, requiring long-term airway management.

Commonly used for patients with COPD (Chronic Obstructive Pulmonary Disease), swallowing difficulties, or frequent nighttime apnea.

Often used with oxygen therapy to improve ventilation efficiency.

Insertion Technique and Care

Adults

Ensure the nasal passage is clear before insertion and apply lubricant to reduce irritation.

Adjust the angle between 45-90 degrees to avoid excessive force that could damage the nasal cavity.

For prolonged use, alternate nostrils periodically to prevent pressure injuries.

Elderly Patients

Due to dry nasal passages, pre-humidification is recommended. A softer PVC NPA can help reduce irritation.

The insertion angle should not exceed 60 degrees to minimize nasal trauma.

Monitor for nasal bleeding or mucosal damage. If issues arise, consider using a smaller size or switching to an alternative airway management method.

Complication Risks and Prevention

For Adults

Common risks include nasal mucosal damage, aspiration, and gag reflex activation.

Prevention: Choose the correct size, ensure adequate lubrication, and insert to the appropriate depth.

For Elderly Patients

More susceptible to nasal bleeding, infections, and soft tissue damage due to fragile blood vessels.

Prevention:

Use softer materials, such as silicone NPAs, to reduce irritation.

Avoid repeated insertions; use humidified oxygen therapy when necessary.

Regularly assess airway condition to prevent long-term pressure ulcers. 

How to Choose the Right Nasopharyngeal Airway

When selecting an NPA, consider the following key factors to ensure optimal performance and patient comfort:

Diameter (Fr)

Adults: 28-32Fr for sufficient airflow and minimal resistance.

Elderly patients: 24-28Fr to reduce irritation and the risk of injury.

Material

• PVC is a common choice for nasopharyngeal airways due to its softness, non-toxicity and durability. PVC nasopharyngeal airways are suitable for short-term use and can also be used for long-term use in certain situations, especially when frequent replacement is required, to help reduce the risk of respiratory complications.

• Silicone is softer and more biocompatible, suitable for long-term wear and reduces irritation to nasal tissue.

• Thermoplastic elastomers (TPE) combine the advantages of silicone and PVC, providing better softness and durability while reducing the risk of allergies.

The doctor should choose the material based on the patient's condition and age.

Length

The NPA should be long enough to reach the airway but not so long that it interferes with the throat. Selecting the right length improves patient comfort and ventilation efficiency. It should be chosen based on the patient's height and anatomical structure.

Tip Design

NPAs with a smooth, beveled tip reduce insertion trauma and improve patient comfort. A well-designed tip enhances both safety and effectiveness.

Disposable vs. Reusable

Disposable NPAs are safer and reduce the risk of infection, making them ideal for hospitals and emergency settings.

Reusable NPAs are more cost-effective but require strict disinfection protocols.

Infection control measures should be prioritized in medical environments.  

Conclusion

You've known the differences in NPA use between adults and elderly patients through the above-mentioned. Therefore, using the right nasopharyngeal airway and proper techniques can reduce complications and improve patient comfort.

Bever Medical specializes in high-quality medical NPAs and provides OEM services. Our nasopharyngeal airways meet international medical standards, offering soft, comfortable solutions for all patient needs. Bever Medical delivers professional solutions for hospitals, emergency care, and personal use. Contact us to learn more!