medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...

, a nasopharyngeal airway, also known as an NPA, nasal trumpet (because of its flared end), or nose hose, is a type of ''airway adjunct'', a tube that is designed to be inserted through the nasal passage down into the posterior pharynx to secure an open

airway The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to th ...

. It was introduced by in 1958. When a patient becomes unconscious, the muscles in the jaw commonly relax and can allow the tongue to slide back and obstruct the airway. This makes

airway management Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either cl ...

necessary, and an NPA is one of the available tools. The purpose of the flared end is to prevent the device from becoming lost inside the patient's nose.

Sizes

As with other catheters, NPAs are measured using the

French catheter scale The French scale, French gauge or Charrière system is commonly used to measure the size of a catheter. It is most often abbreviated as Fr, but can often be seen abbreviated as Fg, FR or F. It may also be abbreviated as CH or Ch (for Charrière, i ...

, but sizes are usually also quoted in millimeters. Typical sizes include: 6.5 mm/28FR, 7.0 mm/30FR, 7.5 mm/32FR, 8.0 mm/34FR, and 8.5 mm/36FR.

Indications and Contraindications

These devices are used by emergency care professionals such as EMTs and paramedics in situations where an artificial form of airway maintenance is necessary, but

tracheal intubation Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic catheter, tube into the vertebrate trachea, trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer ce ...

is impossible, inadvisable, or outside the practitioner's

scope of practice Scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for ...

. An NPA is often used in patients who are conscious or have an altered level of consciousness where an

oropharyngeal airway An oropharyngeal airway (also known as an oral airway, OPA or Guedel pattern airway) is a medical device called an ''airway adjunct'' used in airway management to maintain or open a patient's airway. It does this by preventing the tongue from cov ...

would trigger the gag reflex. The use of an NPA is contraindicated when there is trauma to the face, especially the nose or if there is a suspected skull fracture.

Insertion

The correct size airway is chosen by measuring the device on the patient: the device should reach from the patient's nostril to the earlobe or the angle of the jaw.Daniel Limmer and Michael F. O'Keefe. 2005. ''Emergency Care'' 10th ed. Edward T. Dickinson, Ed. Pearson, Prentice Hall. Upper Saddle River, New Jersey. Page 147. The outside of the tube is lubricated with a water-based lubricant so that it enters the nose more easily. The device is inserted until the flared end rests against the nostril.

References

{{First aid topics Airway management Medical equipment Respiration