A nasopharyngeal tube, also known as a nasal airway or nasal trumpet, is a soft, flexible tube inserted into a patient’s nostril to maintain an open air passage. It assists with breathing by providing a direct route for air.
Understanding How a Nasopharyngeal Tube Works
The nasopharyngeal tube addresses a common physiological problem where the upper airway can become blocked. In situations involving unconsciousness, deep sedation, or certain medical conditions, the muscles in the jaw and pharynx relax, allowing the tongue and other soft tissues at the back of the throat to fall backward. This can obstruct the natural air passage, making it difficult for air to reach the lungs.
Once inserted, the tube creates a clear air passage from the nostril into the pharynx, physically preventing soft tissues from collapsing and blocking airflow. This ensures air moves freely to and from the lungs, supporting oxygenation and ventilation. Made of flexible plastic or rubber, the tube is firm enough to maintain the airway while allowing gentle insertion. Its flared end prevents it from becoming lost inside the nose.
The nasopharyngeal tube is tolerated by conscious or semi-conscious patients with an intact gag reflex, as it bypasses the oropharynx, which often triggers discomfort or vomiting with other airway adjuncts. This stable pathway ensures continuous breathing.
What to Expect with a Nasopharyngeal Tube
Trained medical professionals, such as EMS personnel, nurses, or physicians, typically perform the insertion. Before insertion, the tube is lubricated to facilitate smoother entry and reduce trauma to the nasal passage. Size is determined by measuring the tube from the patient’s nostril to their earlobe or jaw angle.
During insertion, the tube is gently advanced into the nostril, usually at a 90-degree angle to the face, following the nasal passage’s natural curve. Patients might experience some initial discomfort or a brief gag reflex, though it is generally better tolerated than other airway devices in conscious patients. Once in place, the flared end rests against the nostril, preventing further inward movement.
Nasopharyngeal tubes are used in various medical settings, including emergency first aid to secure an airway, post-operative recovery to prevent obstruction from anesthesia, or for patients with altered consciousness needing airway support. They can also be used in patients with conditions like micrognathia or glossoptosis, where anatomical features may lead to airway narrowing or collapse. Placement is typically temporary, ranging from a few hours to several days, depending on the patient’s condition.
Basic care involves keeping the tube clear of secretions, which may require gentle suctioning. Suctioning should be brief, usually within 5-10 seconds, to minimize mucosal damage. While generally well-tolerated, potential complications include nasal passage irritation, minor bleeding (epistaxis), or, rarely, accidental dislodgement. Removal is straightforward once the patient’s airway can be maintained independently.