In what condition is the use of a nasopharyngeal airway contraindicated?

The use of a nasopharyngeal airway is contraindicated in cases of severe facial trauma or suspected skull fractures due to the risk of further injury or complications. In these scenarios, inserting the airway can exacerbate existing injuries, potentially penetrating the cranial cavity or causing additional damage to the nasal passages and structures of the face. This may lead to serious complications, including intracranial hemorrhage or infection, especially if the airway is placed in the context of a skull fracture.

In contrast, mild facial trauma does not generally present the same level of risk, making the nasopharyngeal airway a viable option in those circumstances. An unresponsive patient may often require an airway adjunct to manage their airway, provided that other contraindications, such as the presence of severe trauma, are not present. Similarly, a history of respiratory infections does not inherently preclude the use of a nasopharyngeal airway; rather, caution might be warranted to avoid infection risk, but it is not a strict contraindication. Therefore, the serious nature of severe facial trauma and the potential for increased risk to the patient’s safety and health make it the correct answer in this context.