Field Internship Student Data Acquisition Project. (FISDAP) Airway Practice Exam

What are the indications for using a nasopharyngeal airway (NPA)?

1. Severe head injury with blood draining from the nose

2. Semiconscious/unconscious patient with intact gag reflex

3. History of fractured nasal bone

4. Patient with respiratory arrest

The correct answer is: Semiconscious/unconscious patient with intact gag reflex

The use of a nasopharyngeal airway (NPA) is indicated in patients who are semiconscious or unconscious but still have an intact gag reflex. This is important because the gag reflex ensures that the patient's airway is protected, reducing the risk of aspiration. In this scenario, the NPA can be employed to help maintain airway patency without eliciting a gag response, which could lead to complications. The design of an NPA allows it to be inserted into the nostril and pass into the nasopharynx, providing an unobstructed passage for air without stimulating the gag reflex in a patient who may be unresponsive. In contrast, using an NPA in patients with a severe head injury with bleeding from the nose may increase the risk of further injury or introduce blood into the airway. Similarly, individuals with a history of a fractured nasal bone may not tolerate the placement of an NPA due to possible displacement of the fracture or increased risk of epistaxis. Furthermore, in patients who are in respiratory arrest, other advanced airway management techniques, such as endotracheal intubation or bag-mask ventilation, would generally be prioritized over an NPA.