In which instance should a nasopharyngeal airway (NPA) not be used?

A nasopharyngeal airway (NPA) should not be used in situations where the patient is not tolerant of it because the device can cause discomfort or distress. If a patient is fully conscious and aware, inserting an NPA may trigger a gag reflex or cause anxiety, potentially leading to airway obstruction or respiratory distress.

The use of an NPA is generally contraindicated in situations where the patient's cooperation cannot be guaranteed, as it may exacerbate their condition or provoke adverse reactions. In emergency situations, ensuring the comfort and cooperation of the patient when utilizing airway management techniques is crucial for effective treatment.

In contrast, using an NPA in a patient with a history of asthma is acceptable, provided other contraindications are not present. Similarly, in cardiac arrest scenarios, the priority is maintaining airway patency, and an NPA can be effectively used if the patient's anatomy allows. For fully conscious patients, however, their tolerance is a vital factor to consider, making it essential to assess their ability to withstand such an intervention prior to its application.