When should a nasopharyngeal airway (NPA) be inserted?

A nasopharyngeal airway (NPA) should be inserted primarily to maintain or establish an airway in a casualty who is experiencing airway obstruction or inadequate ventilation. When a casualty is making snoring or gurgling sounds, it indicates that there may be partial obstruction of the airway, often due to the collapse of the tongue into the back of the throat. The NPA is designed to bypass such obstructions by providing a clear passage for airflow.

Additionally, if the casualty's respiratory rate is less than two breaths in fifteen seconds, this suggests significant respiratory distress or an ineffective breathing pattern. The NPA can help facilitate breathing in such situations.

Therefore, both conditions indicate an immediate need for intervention to ensure the casualty can breathe adequately. Once the airway is confirmed to be compromised, inserting an NPA is an appropriate response to restore airflow. This highlights the importance of recognizing signs of airway compromise and acting quickly to address them.