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Nasopharyngeal airways are sometimes used by people who have sleep apnea.
These devices are also used by emergency care professionals such as EMTs and paramedics in situations where an artificial form of airway maintenance is necessary but it is impossible or inadvisable to use an oropharyngeal airway, the preferred type of airway adjunct, or intubate, considered the most certain way to secure a patent airway, but also the most medically invasive. In an unconscious patient, suction of the upper airways may also be applied via an NPA.
Insertion of an NPA is contraindicated in patients with severe head or facial injuries, or have evidence of a basilar skull fracture (Battle's sign, raccoon eyes, cerebrospinal fluid/blood from ears, etc.) due to the possibility of direct intrusion upon brain tissue. An oropharyngeal airway may be used instead, but these devices frequently trigger a patient's gag reflex, while nasopharyngeal airways usually do not.
The correct size airway is chosen by measuring the device on the patient: the device should reach from the patient's nostril to the earlobe or the angle of the jaw. The outside of the tube is lubricated with a water-based lubricant so that it enters the nose more easily. The device is inserted until the flared end rests against the nostril.