Which of the following is an indication for a nasopharyngeal airway (NPA)?

• A. Unconscious casualty with no respiratory distress or airway obstruction
• B. Conscious casualty with gag reflex present
• C. Dehydration casualty
• D. Severe facial trauma

Answer: (A)

An NPA is used to keep the airway open for someone who cannot protect their airway, especially when they are unconscious and do not have facial or nasal injuries. In an unconscious casualty the gag reflex is absent, so a nasal airway can be inserted safely to prevent the tongue or tissues from blocking the airway and to maintain patency. This makes an unconscious person without facial trauma a clear indication for an NPA.

The other scenarios aren’t suitable: a conscious person with a gag reflex present is likely to gag or vomit from nasal insertion; dehydration doesn’t require an airway adjunct; severe facial trauma raises the risk of nasal injury or skull fracture, which is a contraindication to using an NPA.