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What we are going to look at now is nasopharyngeal or NP airways. We would opt to use an NP airway when manual techniques to open the patient's airway are inadequate, or if we need to free our hands up, to do other things. Also, it's useful in a patient who might be fitting or a patient who has a head injury and has trismus, and the teeth are clenched together, and it's not possible to put an oropharyngeal airway in.

We select the size of the nasopharyngeal airway according to the size of the nostril and, as a general guide, the patient's little finger. So, we have sizes from nine, eight, seven, six, and for this particular patient we are going to opt to use a number eight millimetre NP airway. They have a little curve and a flange on the end, to stop the airway disappearing inside the patient's nose. So hold the NP airway in your right hand and aim to insert it into the patient's right nostril first. If the patient's got a head injury, then extreme caution is urged at this stage, given there may well be a fractured base of the skull. So, insert it inside the right nostril in an upward motion, and as we insert, we rotate and slide the airway down.

What normally happens at this stage now is, when it gets in place in the oropharynx at the back, we'll start to get a whoosh of air coming through the airway. We may also get some mucus or some blood, as that's common, so keep your head back when you insert it, my advice.