The nasopharyngeal airway is inserted through the nose and advanced until the tip lies in the hypopharynx proximal to the epiglottis. Traumatic insertion is not unusual and bleeding into the pharynx may exacerbate airway compromise. However, it may be an invaluable airway adjunct in patients with clenched jaws, is an alternative to the oropharyngeal airway if the latter is contraindicated or of limited benefit, and is often better tolerated (once in place) than the oropharyngeal airway if glossopharyngeal reflexes are present. Midfacial fractures, base of skull fractures, and bilateral nasal passage obstruction or deformity would contraindicate use of the nasopharyngeal airway.
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