A nasopharyngeal catheter is a medical device designed to support breathing and manage the airway. It is inserted through a patient’s nose, extending into the nasopharynx, the upper part of the throat behind the nose. This device plays a role in ensuring that air can move freely, which is important for ventilation and oxygen delivery, particularly in settings such as emergency care.
What is a Nasopharyngeal Catheter?
A nasopharyngeal catheter is a thin, flexible tube, often referred to as a “nasal trumpet” due to its flared end. These catheters are typically made from soft, pliable materials such as medical-grade polyvinyl chloride (PVC) or polyethylene furanoate (PEF), which allow for gentle insertion. The design includes a bevelled tip for easier passage and a flared end that remains outside the nostril, preventing the device from slipping entirely into the nasal passage.
The construction of these catheters often incorporates varying degrees of flexibility along their length. The distal end, which goes deepest, is typically more flexible to navigate anatomical curves, while the part closer to the outside may be stiffer for better control during insertion.
When is it Used?
Nasopharyngeal catheters are used in various medical situations to support a patient’s respiratory function. One common use is to maintain an open airway in individuals who are conscious or semi-conscious, especially when an oropharyngeal airway might trigger a gag reflex. They are also employed when a patient’s mouth is difficult to open due to conditions like trismus or angioedema. This makes them a suitable option for patients who can breathe on their own but require assistance to keep their airway clear.
The catheter facilitates the delivery of supplemental oxygen, improving oxygenation for patients experiencing respiratory distress or low blood oxygen levels. It can also be used to assist with suctioning, helping to clear excess mucus, secretions, or blood from the upper airway. This is particularly useful for patients who are unable to cough effectively to clear their secretions. Conditions such as bronchiolitis, which involve significant upper airway secretions, often necessitate nasopharyngeal suctioning.
The Administration Process
The insertion of a nasopharyngeal catheter is a procedure performed by trained healthcare professionals. Before insertion, the appropriate size of the catheter is selected by measuring it against the patient, typically from the tip of the nose to the earlobe or the angle of the jaw. The chosen catheter is then lubricated, usually with a water-soluble gel or anesthetic jelly, to ensure smooth and comfortable insertion and to minimize irritation.
The healthcare professional will gently insert the lubricated catheter into one of the patient’s nostrils. The tube is directed posteriorly, aiming towards the back of the head and along the floor of the nasal cavity, rather than upwards. If resistance is encountered, the catheter may be slightly rotated, or the other nostril might be tried. The catheter is advanced until its flared end rests against the nostril, indicating proper placement, with the tip typically positioned just above the epiglottis.
Once inserted, the catheter is typically secured to prevent accidental dislodgement. This often involves taping the flared end to the bridge of the nose or the cheek. Proper securement ensures the catheter remains in its correct position, providing continuous airway support or allowing for subsequent procedures like suctioning. Monitoring the patient’s breathing sounds after insertion helps confirm effective placement.
Patient Experience and Management
Patients with a nasopharyngeal catheter may experience some initial sensations, including mild discomfort or irritation in the nostril and throat. The presence of the tube might also lead to increased mucus production or a feeling of dryness. Healthcare providers aim to minimize discomfort, sometimes by using lubricants during insertion or by selecting the most appropriate catheter size.
Ongoing management involves regular monitoring of the catheter’s placement and the patient’s condition. Healthcare professionals routinely inspect the insertion site for any signs of irritation, redness, or infection. Maintaining proper hygiene around the catheter is important, which includes cleaning the area with mild soap and warm water daily. Patients are also encouraged to stay well-hydrated, which can help keep secretions thin and easier to manage.
The healthcare team will regularly assess the need for the catheter and ensure it remains clear of obstructions. Suctioning through the catheter may be performed as needed to remove secretions, with each suctioning attempt typically lasting no more than 5-10 seconds. If the catheter is used for oxygen delivery, flow rates are carefully managed to prevent issues like nasal dryness.