RCH@Home Manual: Nasopharyngeal
Tube Care
Table of Contents
1.
2.
3.
4.
5.
Upper airway obstruction ................................................................ 2
Indications for removing and inserting the
nasopharyngeal tube ....................................................................... 2
Removing the nasopharyngeal tube ............................................ 2
Inserting the nasopharyngeal tube ............................................. 2
Responsibilities ................................................................................... 4
Version
3.0
Date revised
January 2015
Next revision date
January 2017
 RCH @ Home, Royal Children's Hospital.
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http://www.rch.org.au/uploadedFiles/Main/Content/hacc/home_care_manuals/RCH@Home%20Disclai
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1. Upper airway obstruction
The nasopharyngeal tube is a thin and clear tube that comes in different sizes. It is placed
in the nostril and passed down the nasal passage to help hold open the nasal airway and
prevent breathing difficulties.
It may be necessary for the carer to suction the nasopharyngeal tube to clear secretions
and to replace it if it falls out. The nasopharyngeal tube can also be suctioned the same
way we would suction the nose or mouth, and the indications for suction are the same and
are described in the ‘suction’ section of the manual.
There will always be two nasopharyngeal tubes in the home; one in use, and a spare.
These should be the same size. Below are the instructions on removal and replacements of
the nasopharyngeal tube.
2. Indications for removing and inserting the
nasopharyngeal tube
Remove and insert a new tube if you think that:

The tube is blocked with secretions and you are unable to clear with suction

After suctioning the child’s breathing does not improve
3. Removing the nasopharyngeal tube
Procedure
1.
Wash hands (can use ABHR)
2.
Put on gloves
3.
Using a suction catheter, suction the tube to the correct length
4.
Gently remove tapes from face
5.
Gently pull the nasopharyngeal tube flange until the end of the tube has cleared
the nostril
6.
Check the child
7.
Wash hands (can use ABHR)
8.
Remove gloves and discard
Wash the old nasopharyngeal tube in warm water, ensuring to wash the inside until all
secretions have been removed. Remove excess water and let the tube drip dry.
4. Inserting the nasopharyngeal tube
If the child coughs or sneezes the tube may become dislodged. The carer can push the
tube gently back into place or if the tube falls out, wash it and replace as per instructions
below:
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Procedure
1.
Wash hands (can use ABHR)
2.
Put on gloves
3.
Moisten the tip of the nasopharyngeal tube with water or water based lubricant
which helps lubricate it to ease insertion
4.
With the tip facing down wards, gently insert the tube into a nostril, using a
curving motion to follow the natural path of the airway. The tube will pass along
the back of the throat, just past the base of the tongue. Unless contraindicated, it
is wise to use alternating nostrils each time the tube is reinserted

The nostrils have a large blood supply and will bleed if traumatised. If any
blood appears in the mouth or nose after insertion use suction to remove
and monitor the child
5.
Initially after insertion, the child may need to be suctioned more than normal, as
the tube may irritate the airway and cause more mucous secretion. This should
settle
6.
A protective dressing such as Comfeel Transparent® can be placed on the child’s
skin to protect from damage. Gently apply securing tape around the exposed end
of the tube, across the bridge of the nose and onto a the closest cheek
7.
Remove and dispose of gloves
 RCH @ Home, Royal Children's Hospital.
This document is subject to a disclaimer, see
http://www.rch.org.au/uploadedFiles/Main/Content/hacc/home_care_manuals/RCH@Home%20Disclai
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8.
Wash hands (can use ABHR)
Monitor the child’s skin integrity, inspecting the nostrils at least once per shift,
ensuring they are pink in appearance. If the nares are white, the tube needs to be retaped to reduce pressure on the nostril.
5. Responsibilities

Always look at the child’s breathing at the start of the shift, and if child’s condition
changes

It is the carer’s responsibility to check that two nasopharyngeal tubes are
available, at the start of the shift

During the shift, it is the carer’s responsibility to insert, change or remove the
nasopharyngeal airway and securing tape when necessary
 RCH @ Home, Royal Children's Hospital.
This document is subject to a disclaimer, see
http://www.rch.org.au/uploadedFiles/Main/Content/hacc/home_care_manuals/RCH@Home%20Disclai
mer.pdf
Page 4 of 4