In emergency medicine and anesthesia, NPAs and OPAs are common airway devices used to keep the airway open. However, medical professionals often notice a key difference: NPAs are usually sterile, while OPAs are not. Why is this the case? This article explains the differences, use cases, contamination risks, and safety concerns of both devices. We will also introduce Bever Medical's NPA and OPA options.   
 

Key Differences Between NPA and OPA  

Before understanding why sterility matters, let's look at the basic differences:  

Nasopharyngeal Airway (NPA)   

1. Inserted through the nose and positioned in the nasopharynx.  

2. It is used for patients with spontaneous breathing but at risk of upper airway obstruction, such as tongue collapse.  

3. Made of soft material to reduce tissue damage.  

4. The nasopharyngeal airway is Suitable for patients with an intact gag reflex and can be used in conscious or semi-conscious states.
    
    

Green Nasopharyngeal Airway

Oropharyngeal Airway (OPA)  

1. Inserted through the mouth and positioned in the oropharynx to prevent the tongue from blocking the airway.  

2. Used for unconscious patients, such as those under anesthesia or during CPR.  

3. The oropharyngeal airway is Made of rigid plastic and must be inserted properly to avoid gagging.  

4. Not for conscious patients, as it may trigger vomiting and aspiration.  

Why Does NPA Need to Be Sterile While OPA Does Not?  

The sterility requirement comes down to insertion path, anatomy, and infection risks. 

NPA Passes Through the Nose, Reaching a Sterile Area

NPA is inserted through the nasal cavity and extends into the nasopharynx, possibly reaching the lower airway, which is relatively sterile. If contaminated, NPA can introduce bacteria, leading to sinus infections, nasopharyngitis, or even lower respiratory infections. 
 

OPA Stays in the Mouth, Which Is Already Full of Bacteria

OPA remains in the mouth, an area naturally populated with microorganisms. Since it only supports the tongue without entering the lower airway, sterility is less critical. Even if OPA carries bacteria, it does not directly cause deep infections.  

NPA Is Often Used for Long Periods, While OPA Is Temporary  

NPA may remain in place for extended periods, such as in ICU patients, post-anesthesia recovery, or difficult airway cases. A non-sterile NPA increases the risk of infection. OPA, on the other hand, is typically used briefly and removed immediately, so sterility is less important.  

When Should a Sterile NPA Be Used?  

NPA is ideal for:  

Patients who are conscious or semi-conscious but at risk of airway obstruction (e.g., trauma, neurological conditions).  

Emergency medical care, such as ambulances or battlefield settings.  

Patients with airway management difficulties, such as facial trauma or restricted jaw movement.  

Anesthesia and post-surgery recovery, preventing airway blockage during waking.  

A sterile NPA reduces infection risks and ensures safe use in these scenarios.  

BEVER Medical Silicone Adjustable Nasopharyngeal

Contamination Risks of OPA and How to Reduce Them  

Although OPA does not need to be sterile, there are still risks:  

• Cross-contamination: Reusing OPAs between patients can spread infections.  

• Aspiration risk: Using OPA incorrectly may trigger a gag reflex, leading to vomiting and aspiration.  

How to Reduce OPA Contamination Risks  

• Use disposable OPAs to prevent cross-infection.  

• Store OPAs properly to avoid contamination.  

• Follow strict cleaning and disinfection protocols for reusable OPAs.  

How a Sterile NPA Improves Patient Safety  

A sterile NPA offers several benefits:  

Reduces infection risk: Prevents nasal bacteria from reaching the lower airway.  

Safe for long-term use: Essential for ICU and post-surgery recovery.  

Fewer complications: Minimizes the introduction of pathogens during insertion.   

How to Store and Use a Sterile NPA  

Storage

Keep in sterile packaging until use.  

Store in a clean, dry area to avoid contamination.  

Usage

1. Select the correct size for patient comfort and effective airflow.  

2. Use sterile gloves or clean hands for handling.  

3. Lubricate the NPA to ease insertion and prevent mucosal injury.  

4. Secure in place to prevent displacement. 

Conclusion  

Both NPA and OPA serve vital airway management roles. Since NPA enters the airway and may stay in place longer, sterility is crucial. OPA, which remains in the mouth for short periods, does not require sterility.  

For medical institutions seeking high-quality airway devices, Bever Medical offers a range of sterile NPAs and high-quality OPAs to ensure safe and effective airway management. Visit our website to learn more.