Rusch PVC Nasopharyngeal Airway

Is the Rusch NPA CoTCCC recommended?

Yes. The nasopharyngeal airway (NPA) is a CoTCCC-recommended airway adjunct for managing unconscious or semi-conscious casualties who cannot protect their own airway. The Rusch PVC NPA by Teleflex is the benchmark NPA used in military and tactical medicine — its soft PVC construction, beveled tip, and latex-free materials meet CoTCCC specifications for airway management in the Tactical Field Care and Prolonged Field Care phases.

What is the difference between Kit #1 (12–24 FR) and Kit #2 (24–36 FR)?

Kit #1 (553324K) covers French sizes 12 through 24, providing seven airways sized for pediatric patients through smaller adults. Kit #2 (553325K) covers sizes 24 through 36, providing seven airways sized for average to large adults — including the 28–32 FR range most commonly used for adult male military casualties. Most tactical medical kits focused on adult populations will use Kit #2, while pediatric or civilian emergency kits benefit from Kit #1.

How do I select the correct NPA size for a patient?

The standard sizing method is to measure from the patient's nostril to the earlobe — the appropriate NPA length should approximate this distance, placing the distal tip in the nasopharynx without entering the esophagus. For most adult males, a 28–32 FR NPA (Kit #2) is appropriate. Overtly large NPAs may stimulate a gag reflex or cause bleeding; undersized NPAs will not adequately stent the airway open.

Can the Rusch NPA be used on a patient who is still semi-conscious?

Yes. The NPA is specifically advantageous over the oropharyngeal airway (OPA) for semi-conscious patients because it does not require an absent gag reflex for insertion. Patients with a partial gag reflex — common in traumatic brain injury, intoxication, or shock — typically tolerate the NPA when properly sized. This makes the NPA the preferred airway adjunct in most tactical casualty care scenarios.

Does the Rusch NPA include a lubricant for insertion?

The Rusch PVC NPA kits include the airways themselves; lubricant is not typically included in the multi-pack kit format. Tactical medics and EMS providers should carry a water-soluble lubricant (such as surgical gel or petroleum-based lubricant) alongside NPAs to facilitate atraumatic insertion through the nasal passage. Adequate lubrication reduces insertion force and minimizes mucosal trauma significantly.