nasopharyngeal airway
{{short description|Tube inserted through the nose into the throat as an artificial airway}}
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Name = Nasopharyngeal airway |
Image = Wendltubus.jpg |
Caption = Nasopharyngeal airway. |
ICD10 = |
ICD9 = {{ICD9proc|96.01}} |
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OPS301 = |
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In medicine, a nasopharyngeal airway (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. It was introduced by {{ILL|Hans Karl Wendl|de}} in 1958.Wendl H K. The story of the Wendl tube and its use. In: Schulte am Esch J, Goerig M (eds.) Proceedings of the Fourth International Symposium on the History of Anaesthesia. DrägerDruck, Lübeck, 1998, S. 531–534 When a patient becomes unconscious, the muscles in the jaw commonly relax and can allow the tongue to slide back and obstruct the airway.{{cite book|author=James R. Sills|title=The Comprehensive Respiratory Therapist Exam Review – E-Book: Entry and Advanced Levels|url=https://books.google.com/books?id=XSxTBwAAQBAJ&pg=PA336|date=16 March 2015|publisher=Elsevier Health Sciences|isbn=978-0-323-24188-5|pages=336–}} This makes airway management 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.{{cn|date=February 2022}}
Sizes
As with other catheters, NPAs are measured using the French catheter scale, but sizes are usually also quoted in millimeters.{{cite book|author1=American Academy of Orthopaedic Surgeons (AAOS)|author2=Nancy L. Caroline|title=Nancy Caroline's Emergency Care in the Streets|url=https://books.google.com/books?id=UqEuDwAAQBAJ&pg=PA801|date=15 August 2017|publisher=Jones & Bartlett Learning|isbn=978-1-284-10488-2|pages=801–}}{{cite book|author1=Mick J. Sanders|author2=Lawrence M. Lewis|author3=Kim D. McKenna|author4=Gary Quick|title=Mosby's Paramedic Textbook|url=https://books.google.com/books?id=PJyhIH8N8qgC&pg=PA436|year=2012|publisher=Jones & Bartlett Publishers|isbn=978-0-323-07275-5|pages=436–}} 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 is impossible, inadvisable, or outside the practitioner's scope of practice. An NPA is often used in patients who are conscious or have an altered level of consciousness{{Citation |last1=Atanelov |first1=Zaza |title=Nasopharyngeal Airway |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK513220/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30020592 |access-date=2022-09-14 |last2=Aina |first2=Titilopemi |last3=Amin |first3=Bhavesh |last4=Rebstock |first4=Sarah E.}} where an oropharyngeal airway would trigger the gag reflex.{{cite book|author=Churchill Livingstone Elsevier|title=Textbook of Paediatric Emergency Medicine, 2nd Ed|url=https://books.google.com/books?id=w6xWDwAAQBAJ&pg=PA476|date=23 April 2012|publisher=Bukupedia|isbn=978-0-7020-3368-1|pages=476–}}{{Dead link|date=October 2023 |bot=InternetArchiveBot |fix-attempted=yes }}{{cite book|author1=Rachel K. Thomas|author2=Elize Richards|author3=Cathy Taylor|title=Practical Medical Procedures at a Glance|url=https://books.google.com/books?id=lZmLBgAAQBAJ&pg=PA59|date=27 April 2015|publisher=John Wiley & Sons|isbn=978-1-118-63285-7|pages=59–}} 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.{{Citation |last1=Atanelov |first1=Zaza |title=Nasopharyngeal Airway |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK513220/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30020592 |access-date=2022-09-14 |last2=Aina |first2=Titilopemi |last3=Amin |first3=Bhavesh |last4=Rebstock |first4=Sarah E.}}
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.{{cite book|author1=Michael Smith|author2=Mike Smith|author3=American Academy of Orthopaedic Surgeons|title=ACLS for EMT-Basics|url=https://books.google.com/books?id=MgmXBz9YgwIC&pg=PA17|date=April 2006|publisher=Jones & Bartlett Learning|isbn=978-0-7637-4395-6|pages=17–}} The device is inserted until the flared end rests against the nostril.
References
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{{Emergency medicine}}
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