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2-Step Nasopharyngeal Airway (NPA) Insertion

2-Step Nasopharyngeal Airway (NPA) Insertion

Please note that this is a quick product demo. For official training and more details, you can visit TMS University.

The NPA is the airway adjunct of choice for the tactical environment.

Setup: NPA Orientation

The NPA is a flexible tube consisting of a flange at one end and a bevel at the other end. When inserted the bevel should be oriented toward the septum.

Step 1: NPA Lubrication

To ease insertion, the provided lubricant should be applied to the NPA. If lubricant is not available, the casualty's saliva or blood may be used. Lubricate as much of the tube as possible. 

NPA lubrication


Step 2: NPA Insertion

To insert the NPA, ensure the bevel end is toward the septum and gently insert. Notice the medic is not orienting the tube toward the top of the head. Instead, he is directing it almost straight back toward the back of the head.

If resistance is met, it may be necessary to gently rotate the NPA. If the the casualty still does not accept, attempt the other nostril. The NPA should be inserted until the flange is touching the nose. 

NPA fully inserted


  • Lubrication is the key
  • The right nostril is generally the nostril of choice
  • Consider contraindications
  • Follow your local protocols

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