The Anesthesia Record

Both Kathleen O'Connor, our CRNA airway anatomy lecturer, and Dr. Steve Galyon, our cadaver lab instructor, mentioned a common mistake made by health care professionals when accessing the nasopharynx during nasal intubation, NT suctioning, nasogastric tube insertion, or nasal airway placement. Many of us - myself included - did so using a "rainbow" motion, as if following the angle of the patient's nose. This, however, can cause internal damage to the tissues of the nasal cavity as the Superior, Middle, and Inferior Nasal Concha often impede this route, as illustrated by the diagram below.


Instead, the proper way to pass the device is to direct the instrument across the base of the nasal cavity. This means that if your patient is lying in a supine position, you should be aiming for the floor (perpendicular to the patient).

Once that's completed, the only thing left to do is push this:



[Click on diagram for source information]