i. Choose correct size, with diameter approximating that of nares, and length approximating distance from tragus of ear to tip of nose.
ii. Apply topical vasoconstrictor to nares and lubricant to tube.
iii. Insert tube straight back into nares such that angled side faces turbinates.
iv. Assess fit and effect. With proper fit, nares should not blanch and tip should be just visible behind uvula. If tube is too long, the end may cause gagging or reflex laryn-gospasm or bradycardia through vagal stimulus.
v. Reassess frequently. NP airways are narrow and likely to become obstructed with secretions, and require frequent reassessment. Long-term use may contribute to mucosal irritation and sinus obstruction.
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