In which situation is a nasopharyngeal airway contraindicated?

A nasopharyngeal airway (NPA) is a useful tool for maintaining airway patency, especially in patients who are semi-conscious or unconscious but still have some protective airway reflexes. However, it is important to consider certain contraindications to avoid causing further harm.

In the case of severe facial or head trauma, especially if there is significant cranial or facial fracture, the insertion of an NPA can lead to complications. The nasal cavity could be compromised, and there is a risk of improper placement, which can potentially injure the base of the skull or exacerbate existing injuries. Such trauma increases the chances of entering the cranial vault or causing further bleeding.

Other situations, such as mild respiratory distress, altered mental status, and obstructive sleep apnea, may allow for the safe use of an NPA provided there are no other contraindications, as these scenarios do not inherently involve the risk of injury associated with severe facial or head trauma.