Dispositivo nasofaríngeo para vías respiratorias con gelatina lubricante

What sizes does the Rusch Nasopharyngeal Airway with Lubricating Jelly come in?

The Rusch NPA is available in eight French sizes: 22 Fr, 24 Fr, 26 Fr, 28 Fr, 30 Fr, 32 Fr, 34 Fr, and 36 Fr. Each size is individually packaged with an attached surgical lubricant packet. The 28 Fr is the CoTCCC-recommended default size for average adult males and is the most commonly stocked size in tactical medical kits, IFAKs, and prehospital bags.

Is the Rusch NPA CoTCCC-recommended?

The 28 Fr nasopharyngeal airway is CoTCCC-recommended as the primary airway adjunct for unconscious or obtunded trauma casualties in Tactical Field Care. The Committee on Tactical Combat Casualty Care (CoTCCC) guidelines specify NPA insertion as the first-line airway intervention before considering supraglottic airways or surgical airways. The Rusch 28 Fr NPA meets these specifications as a soft, flexible, latex-free airway with atraumatic insertion characteristics.

Can the Rusch NPA be used on a patient with an intact gag reflex?

Yes — unlike oropharyngeal airways (OPAs), nasopharyngeal airways are better tolerated by semi-conscious patients with an intact gag reflex. The NPA bypasses gag-triggering zones of the oral cavity and is the preferred choice when a patient has any level of consciousness or protective airway reflexes. The soft PVC material further reduces stimulation compared to harder airway devices.

When should the Rusch NPA NOT be inserted?

The primary absolute contraindication is suspected basilar skull fracture, where there is risk of intracranial tube placement. Warning signs include Battle's sign (bruising behind the ear), raccoon eyes (periorbital bruising), or clear fluid (CSF) from the nose or ears. Severe midface trauma is also a contraindication. Relative cautions include coagulopathy (increased epistaxis risk), recent nasal surgery, and known obstructing nasal pathology.

What is the difference between the 22 Fr and 36 Fr Rusch NPA sizes?

French sizing refers to the outer circumference of the tube — 1 French = 1/3 mm in outer diameter. A 22 Fr NPA has an outer diameter of approximately 7.3 mm (suitable for smaller females or older pediatric patients) while a 36 Fr has an outer diameter of approximately 12 mm (for very large adult males). Selecting the correct size improves both comfort and airway patency — an NPA that is too small may not adequately bypass obstruction, while one that is too large may cause epistaxis or pressure necrosis. The nares-to-tragus measurement method provides a reliable field estimate of correct length.