When would you not use nasopharyngeal airway when it seems to be indicated?

A nasopharyngeal airway, (aka NPA or a nasal trumpet), is a tube inserted into the nasal passageway of an unconscious victim to provide an open airway (when unconscious the jaw muscles relax and the tongue to falls back obstructing the airway).

If your patient presents with one or more of the following, you would NOT use a nasopharyngeal airway:

• severe maxillofacial trauma,
• periorbital echymosis,
• retroauricular echymosis,
• significantly deformed nares or septum.

• NOTE: nasopharyngeal airways are CONTRAINDICATED in severe head or facial injuries (bruising behind the ears, raccoon eyes, blood or clear fluid leaking out of the ears or nose), patients on anticoagulants, patients with nasal infections, and patients with nasal deformities.

This may indicate a brain injury
This may indicate a brain injury.