2.

Insertion of Nasopharyngeal Airway (*)

 A soft plastic tube inserted via the nose
with its tip lies behind the tongue just
above the glottis
 Better tolerated by obtunded patients or
those with clenched jaws or in convulsion
 Correct size: from the tip of the nose to
the earlobe
 Lubrication + vasoconstriction nasal spray
facilitate insertion
 Can be used in patients with intact gag
reflex, trismus or oral trauma (Cf OPA)
 Contraindicated in patients with mid-face or base-of -skull fractures

III Ventilation Technique

1. Expired Air Ventilation

 expired air contains 16% O2
 start with 2 slow expired breath of air, each lasting about 1 sec.
 avoid rapid insufflation because it will cause air to enter stomach,
increasing chance of regurgitation
 American Heart Association, USA (JAMA Vol. 268, No. 16, page
2196): The probability of acquiring HIV or HBV infection after
performing CPR is minimal. Transmission of HIV or HBV during
mouth-to-mouth resuscitation has not been documented.

2. Expired Air Ventilation Via Simple Protective Devices: Pocket

Masks
 Allow mouth to mask ventilation without
direct contact with victim
 Protection further enhanced by attaching a
one-way valve
 The oxygen port allows FiO2 of 50% at
10L/min