In order to make safer and more effective decisions quickly in emergency situations, it is very necessary to know the applicability of the two airway tools. This is very helpful for first responders, medical staff or ordinary people who want first aid knowledge. As a supplier of airway management products, Bever Medical will share with you when to use NPA instead of OPA today.

Differences Between NPA and OPA Functions  

Nasal pharyngeal airways (NPA) and oropharyngeal airways (OPA) are commonly used airway management products in clinical practice to maintain airway patency. They share similar purpose, but they differ significantly in design, mechanism of action, and applicable scenarios:  

1. NPA Functions 

NPA (Nasal pharyngeal airways) is a soft, tubular device inserted through the nasal passage to extend into the nasopharynx, creating an artificial airway. It bypasses soft tissue obstructions in the upper airway, ensuring airflow in cases where the patient cannot open their mouth. Its flexible material and lubricated surface enhance patient comfort during insertion, making it particularly suitable for patients with intact gag reflexes.  

2. OPA Functions 

OPA (oropharyngeal airways), made of rigid, curved plastic, is inserted through the mouth and positioned along the tongue to reach the posterior pharyngeal wall. It prevents airway obstruction by displacing the tongue anteriorly, thus maintaining a clear passage. Due to its firm design and direct interaction with the tongue, OPA is most appropriate for unconscious patients without a gag reflex, as its use in conscious individuals may induce discomfort or vomiting.  

Pre-Lubricated Nasal Airway

Scenarios for Using NPA  

1. Patients Unable to Open Their Mouths  

NPA is ideal for patients with clenched jaws or oral injuries, such as those experiencing a seizure. It provides an alternative airway route through the nasal passage when the oral route is inaccessible.  

2. Patients with an Intact Gag Reflex  

For conscious or semi-conscious patients, OPA is often intolerable due to its rigid structure and potential to trigger the gag reflex. NPA, being softer and less invasive, is a more comfortable and viable option.  

3. Presence of Facial or Oral Trauma  

In cases of facial burns, maxillofacial fractures, or oral trauma where the use of OPA is contraindicated, NPA can bypass the affected area and provide effective airway support.  

4. Temporary Airway Support  

NPA is frequently used in emergency situations requiring short-term airway management, such as during CPR or at accident scenes, due to its quick insertion and ease of use.  

Scenarios for Using OPA  

1. Unconscious Patients  

OPA is highly effective for unconscious patients, such as those under general anesthesia or in cardiac arrest, as it prevents the tongue from collapsing and obstructing the airway.  

2. Patients Without a Gag Reflex  

Since OPA contacts the posterior pharyngeal wall, it may provoke gagging or vomiting in patients with an intact reflex. Therefore, it is only suitable for unconscious individuals lacking this reflex.  

3. Long-Term Airway Support  

In scenarios requiring a stable airway for a prolonged period, such as intraoperative or postoperative care, OPA ensures a reliable airway while allowing easy access for healthcare monitoring.  

4. Emergency Airway Management  

In hospital or pre-hospital settings, OPA is often the first choice for managing airway obstruction in unconscious patients due to its rapid deployment and effectiveness.  

Factors Influencing the Choice Between NPA and OPA  

Selecting between NPA and OPA requires a comprehensive assessment of the patient's condition. Key factors include:  

1. Patient’s Level of Consciousness  

For conscious or semi-conscious patients, NPA is preferred as it avoids stimulation of the posterior pharyngeal wall, reducing discomfort. Conversely, OPA is better suited for unconscious patients requiring stable airway support.  

2. Anatomical Considerations  

Structural anomalies, such as nasal septal deviation, may hinder NPA insertion. Similarly, oral abnormalities, such as maxillofacial trauma or severe dental malocclusion, may limit OPA use.  

3. Urgency of the Situation  

In critical airway emergencies, such as cardiac arrest, OPA is often chosen for its rapid insertion and immediate resolution of obstructions. If the mouth cannot be accessed, NPA becomes the only viable option.  

4. Patient History  

Patients with a history of nasal bleeding or nasal surgery may not be suitable for NPA. Similarly, individuals allergic to latex should avoid using latex-based OPA devices.  

Risks and Precautions for Using NPA and OPA  

1. Risks Associated with NPA  

• Nasal Bleeding: Improper insertion or fragile nasal mucosa can cause bleeding. Adequate lubrication and avoiding forceful insertion minimize this risk.  

• Sinus Infection: Prolonged NPA use increases the risk of infection, necessitating regular replacement and sterile handling.  

• Misplacement: Incorrect placement may result in airway obstruction or even aspiration. 
  
  

2. Risks Associated with OPA  

• Vomiting and Aspiration: OPA may induce gagging and vomiting in patients with a functional gag reflex, potentially leading to aspiration of gastric contents into the lungs.  

• Oral Trauma: Excessive force during insertion may damage teeth or oral tissues.  

• Worsened Obstruction: Incomplete insertion of OPA can push the tongue backward, exacerbating airway blockage.  
  
  

3. Common Precautions  

• Both two airway management products must use appropriately sized devices to ensure effective and comfortable insertion.  

• Closely monitor the patient's breathing post-insertion to confirm airway patency.  

• Adhere to strict aseptic techniques to prevent infections.  

Conclusion  

Although this article provides the situation of choosing NPA instead of OPA, there are some situations that need to be combined with patient needs. Simply put, NPA is more suitable for patients with trismus, gag reflex, or facial trauma. Additionally, high-quality airway management products like those provided by Bever Medical are made of safe PVC and silicon medical materials. And OE services can meet the needs of patients and provide them with suitable materials and designs, providing safer and more comfortable solutions for airway management.