Nasopharyngeal Airway Advantages and Disadvantages

To know nasopharyngeal airway advantages and disadvantages, we first explained what the nasopharyngeal airway is. Nasopharyngeal airway is one of the two most common types of airway management devices, the other type being oropharyngeal airway. Secondly we discussed where the nasopharyngeal airway is most suitably used. The uses of any medical device in comparison with its related other types prompt the thought of what are its advantages and disadvantages. The content arrangement of this article has been designed to provide an answer to this question that people are intrigued to ask.

Nasopharyngeal Airway and Oropharyngeal Airway

1) Nasopharyngeal Airway (NPA)

A nasopharyngeal airway (NPA) is a flexible tube inserted through the nostril into the nasopharynx to maintain an open airway.

Key Features

Material: Typically made from soft, flexible rubber or silicone.

Bevel: The tip is angled (beveled) to facilitate insertion.

Flange: The wider part at the top prevents the NPA from being inserted too far.

Lubrication: Requires lubrication (usually water-based) for smoother insertion.

2) Oropharyngeal Airway

An oropharyngeal airway (OPA) is a rigid, curved plastic device used to maintain a clear airway by preventing the tongue from falling back and obstructing the oropharynx. It is used in patients who are unconscious or deeply sedated, where the gag reflex is absent (otherwise the device will stimulate the patient and cause gagging and even vomiting). The device is inserted into the mouth, and its curved shape helps to hold the tongue in place, keeping the airway open.

Key Features

Material: Typically made of rigid plastic.

Flange: The flat end (flange) remains outside the mouth, preventing the device from being inserted too far.

Curved Design: The shape conforms to the tongue and the oropharynx, holding the tongue away from the airway.

Situations Where a Nasopharyngeal Airway Can be Used

A nasopharyngeal airway can be used in the following situations suitably.

1) Semi-conscious or Conscious Patients with an Intact Gag Reflex

Semi-conscious or conscious patients usually have an active gag reflex, which means that they cannot tolerate an oropharyngeal airway (OPA). If an oropharyngeal airway is inserted it will stimulate the posterior pharynx and cause reaction of gagging.

The gag reflex may trigger vomiting, which introduces a risk of aspiration (inhalation of stomach contents into the lungs), potentially leading to aspiration pneumonia.

Instead of maintaining an open airway, gagging and vomiting can cause further airway obstruction, as the patient’s tongue or vomit could block the airway.

2) If the tongue or soft palate collapse and block the airway in the oropharynx, the nasopharyngeal airway acts as a "stent" to keep the airway open, preventing this collapse. The NPA physically holds the airway open by ensuring soft tissue doesn't block the passage of air through the pharynx.

Nasopharyngeal Airway Advantages and Disadvantages

1) Nasopharyngeal Airway (NPA) Advantages

Ease of Insertion: Nasopharyngeal airways are relatively simple to insert and can be done with minimal equipment.

Comfort: Generally more comfortable for conscious or semi-conscious patients compared to oropharyngeal airways, as nasopharyngeal airways do not provoke a gag reflex. In a conscious or semi-conscious patient, the gag reflex is present. If you insert an oropharyngeal airway in the patient the oropharyngeal airway will stimulate the patient and cause gagging and even vomiting.

Maintains Airway Patency: A nasopharyngeal airway (NPA) is designed to bypass obstructions in the upper airway, often caused by the tongue falling back in unconscious patients. When an NPA is inserted, it passes through the area where the tongue is obstructing the airway. It helps maintain an open airway by physically displacing the tongue and other soft tissues that might be blocking the passage, allowing air to flow more freely into the trachea and lungs. A nasopharyngeal airway helps to push the tongue and other tissues away from the airway, which can relieve the obstruction.

Suitable for Facial Injuries: Can be used in patients with facial trauma where an oropharyngeal airway might not be appropriate.

Less Risk of Trauma: Less likely to cause damage to the oral cavity or teeth compared to oropharyngeal airways.

2) Nasopharyngeal Airway (NPA) Disadvantages

Size Limitations: Requires correct sizing to be effective and safe; improper sizing can cause discomfort or damage.

Potential for Trauma: Insertion can cause nasal or pharyngeal trauma, especially in patients with nasal injuries or bleeding disorders.

Not Suitable for All Patients: May not be effective or appropriate for patients with severe facial injuries or those with nasal/midface trauma.

Limited to Upper Airway Obstruction: NPAs do not address obstructions in the lower airway or lung issues.

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