Nasopharyngeal Airway (NPA) Contraindications: When to Avoid Use

Contraindications for nasopharyngeal airway (NPA) insertion include:

1. Known/suspected nasal or facial trauma: Risks further damage, bleeding.
2. Severe nasal congestion/obstruction: Deviated septum, polyps may prevent effective airway.
3. Severe gag reflex: Causes discomfort, interferes with airway maintenance; consider oropharyngeal airway or bag-mask ventilation.
4. Neurological swallowing disorders: Stroke, bulbar palsy increase aspiration/laryngospasm risk.
5. Uncooperative/combative patients: Safety of patient and provider compromised.
6. Anatomical abnormalities: Rare nasal variations impeding placement.

In these situations, select alternative airway management techniques based on patient needs.