Nasopharyngeal Airway Insertion

  1. Perform hand hygiene and don personal protective equipment. 
  2.  Prepare the nasopharyngeal airway. 
  3. Inspect for smooth edges. 
  4. Generously lubricate the tip and outer cannula with water-soluble lubricant. 
  5. Remove excess secretions from naris. 
  6. When difficult insertion is anticipated (e.g., with nasal polyps, septal deviation), apply topical anesthetic to   cotton swabs, insert as far as possible, and coat the nasal passageway. 
  7. Gently slide airway into nostril. Guide it medially and downward along the nasal passage. 
  8. Ask patient to open his or her mouth, or hold patient's mouth open. Control tongue with a tongue depressor. Illuminate oral cavity and visualize tip of nasopharyngeal airway behind uvula. 
  9. Verify patency of airway. Feel for air movement over the flange. Auscultate breath sounds bilaterally. 
  10. Secure airway by taping it in place. 
  11. Suction secretions as needed. 
  12. Reassess patient's respiratory status. 
  13. Document in patient record.