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When should a Nasopharyngeal Airway (NPA) be used?

  1. When the patient is conscious

  2. In patients with a gag reflex

  3. When OPA is not appropriate

  4. All of the above

The correct answer is: When OPA is not appropriate

A Nasopharyngeal Airway (NPA) is indicated specifically in situations where an oropharyngeal airway (OPA) is not appropriate. This can include cases where the patient is conscious and has an intact gag reflex, as an NPA can be tolerated better by alert patients compared to an OPA, which may stimulate the gag reflex and cause discomfort or airway obstruction. The NPA is a flexible tube inserted through the nostril to maintain airway patency in patients who may have a compromised airway but can still maintain some level of consciousness and motor function. In contrast, an OPA is only used in unconscious patients or those without a gag reflex, as it can lead to aspiration if used incorrectly in conscious patients. Using an NPA allows for a secure airway while reducing the risk of triggering a gag reflex, making it suitable when an OPA is inappropriate due to the patient's level of responsiveness or gag reflex status. Thus, the use of an NPA is a critical skill for maintaining airway management effectively in various clinical scenarios.