Nasopharyngeal intubation secures a patient’s airway by inserting a tube through the nose and into the pharynx prior to advancing it to the trachea. If a patient is having difficulty breathing, this can ensure that enough oxygen reaches the lungs to meet the patient’s needs. This technique can also be used for some types of surgery, where an oropharyngeal approach through the mouth would not be appropriate. It may be performed by paramedics and other first responders in the field, as well as doctors in hospital settings.
In this approach to intubation, the patient usually receives a numbing spray, if conscious, to limit pain during the airway insertion. The medical professional carefully pushes a tube into the nose, taking care to avoid forcing it, as this could cause injuries. Once it hits the pharynx, the care provider can use a laryngoscope to look into the throat, visualize the vocal cords, and move the tube into the trachea to complete the nasopharyngeal intubation. This allows air and anesthetic gases to circulate into the lungs, where gas exchange distributes them into the body.
Emergency situations may call for nasopharyngeal intubation if an oral airway is not possible. This technique is not recommended if a patient has signs of head trauma because it could exacerbate injuries, and care providers must evaluate carefully to decide if they should intubate and which approach should be used. Once the patient is transported to a medical facility for advanced care, the tube may be removed or adjusted.
Surgical procedures on the throat and mouth may necessitate nasopharyngeal intubation. An oral airway would make it hard for the surgeon to see, which could restrict the ability to perform the procedure. This airway approach may also be recommended for a patient who needs to be intubated for an extended period of time due to the inability to breathe independently. Nasopharyngeal intubation is sometimes better tolerated and more comfortable, and there’s also a reduced risk of choking or coughing on the tube in the airway.
The longer a patient is intubated, the higher the risk of complications. People can develop infections in the airway if the tube is not properly maintained. If mechanical ventilation was used to help a patient breathe or deliver anesthetic gases mixed with oxygen, the patient’s lungs may have lost some elasticity and tone. Breathing exercises help patients redevelop strength so they can breathe independently and expel any mucus that builds up in the airways.