When should a nasopharyngeal airway (NPA) be used?

A nasopharyngeal airway (NPA) is primarily indicated for use in patients who have an intact gag reflex. An NPA can be a valuable tool for airway management, as it helps to maintain an open airway in semi-conscious patients who can still protect their airway. The presence of an intact gag reflex indicates that the patient's airway reflexes are functioning adequately, minimizing the risk of the airway being compromised by the device itself.

Using an NPA in patients with an intact gag reflex allows for easier and safer ventilation, as it can be tolerated better by these patients without causing significant discomfort or causing them to gag. It's important to select this option when considering airway interventions, as the risk of airway trauma or obstruction increases in patients whose reflexes are diminished.

In contrast, the other conditions listed—such as complete unresponsiveness, suspected stroke, or frequent suctioning—may not present the safest scenario for utilizing an NPA. In complete unresponsiveness, for instance, there’s a high risk of the airway being blocked by the patient's tongue or secretions, making an alternative airway management method more appropriate.