Insertion of NPA

Question 1

Indications for NPA (1)

Answer 1

1. Unconscious pt presenting with truisms, where an OPA cannot be inserted.

Question 2

Contraindications for NPA (3)

Answer 2

1. Middle third facial trauma - possible intrusion into brain
2. Significant nasal trauma - May induce gag increasing ICP
3. TBI or neuro event where airway is patent and tidal volume is adequate despite truisms- may induce gag and increase ICP

Question 3

Precautions for NPA (2)

Answer 3

1. Basal skull fractures and any CSF from nares or ears as could be intrusion into brain tissue
2. NPA can be removed during ETT as can obstruct view