How to use a nasopharyngeal airway (NPA)

What is an NPA?

• A flexible rubber tube which goes through the nose ends at base of tongue (an adjunct to help keep airway open)
  • An oxygen mask or bag mask ventilation can be applied over the top if needed
• Use: prevents tongue covering epiglottis in patients with reduced GCS. It is tolerated better than oropharyngeal airways in more alert patients.
• Size: Average height females require a size 6 NPA and average height males a size 7 NPA (Portex sizing)
  • Sizing using the patient’s finger as a guide is no longer recommended.

How to insert an NPA

• Lubricate the nasopharyngeal airway with water-soluble jelly
• Insert into the nostril (preferably right) vertically along the floor of the nose with a slight twisting action
  • Aim towards the back of the opposite eyeball
• Confirm airway patency

• Click here for more details on NPAs

Video on NPA insertion

Sizes of NPA

Nasopharyngeal airways (NPAs). The addition of safety-pins to the flanged end prevents them being lost into the oropharynx.

Other airway pages

• How to use an oropharyngeal airway

• How to use a supraglottic airway

• What is an endotracheal tube (ETT?)

• What is a tracheostomy?