What should be done if a patient begins to cough violently immediately after the insertion of a nasopharyngeal airway?

• A. Remove and lubricate the airway, then reinsert through the other nare
• B. Spray Lidocaine in the oropharynx
• C. Obtain and insert a shorter airway
• D. Switch to an oral pharyngeal airway

Answer: (C)

When a patient begins to cough violently immediately after the insertion of a nasopharyngeal airway, it indicates that the airway may be too long for the patient or improperly positioned, causing irritation of the airway structures. Inserting a shorter airway can alleviate this discomfort and reduce the likelihood of triggering a cough reflex. A shorter nasopharyngeal airway may also ensure better fit and position, promoting effective ventilation and reducing trauma to the nasopharynx.

This option is particularly important in emergency situations where maintaining airway patency is crucial. By switching to a shorter airway, the chances of successful placement are improved, and it allows for better breathing mechanics without inducing further coughing or distress to the patient. Other responses, such as lubricating the existing airway or switching to an oral pharyngeal airway, may not address the immediate issue of irritation effectively and could pose additional risks or complications.