When is it appropriate to insert a nasopharyngeal airway?

Inserting a nasopharyngeal airway (NPA) is typically appropriate when the casualty is unresponsive and unable to maintain their own airway. While the indication provided is about the casualty breathing, the primary use of an NPA is to maintain airway patency in situations where other means of airway management might not be effective or appropriate.

An NPA should ideally be used in cases where the individual is unconscious and has a reduced level of consciousness but is still breathing adequately. This helps to keep the airway open, especially when there is a risk of airway obstruction due to the tongue falling back or other factors related to decreased responsiveness.

Using an NPA on a conscious person may induce gag reflexes, and it is generally contraindicated in cases of suspected skull fractures, particularly those that might compromise the nasal passage. Thus, while the individual being “breathing” is an important factor, it’s not the full criterion for when to use an NPA effectively. The focus must be on the need for securing the airway, particularly when the casualty lacks the ability to do so themselves.