<P> The ingestion and aspiration of foreign objects poses a common and dangerous problem in young children . It remains one of the leading cause of death in children under the age of 5 . Common food items (baby carrots, peanuts, etc .) and household objects (coins, metals, etc .) may lodge in various levels of the airway tract and cause significant obstruction of the airway . Complete obstruction of the airway represents a medical emergency . During such crisis, caretakers may attempt back blows, abdominal thrust, or the Heimlich maneuver to dislodge the inhaled object and reestablish airflow into the lungs . </P> <P> In the hospital setting, healthcare practitioners will make the diagnosis of foreign body aspiration from the medical history and physical exam findings . In some cases, providers will order chest radiographs, which may show signs of air - trapping in the affected lung . In advanced airway management, the inhaled foreign objects, however, are either removed by using a simple plastic suction device (such as a Yankauer suction tip) or under direct inspection of the airway with a laryngoscope or bronchoscope . If removal is not possible, other surgical methods should be considered . </P> <P> Supraglottic techniques use devices that are designed to have the distal tip resting above the level of the glottis when in its final seated position . Supraglottic devices ensure patency of the upper respiratory tract without entry into the trachea by bridging the oral and pharyngeal spaces . There are many methods of subcategorizing this family of devices including route of insertion, absence or presence of a cuff, and anatomic location of the device's distal end . The most commonly used devices are laryngeal masks and supraglottic tubes, such as oropharyngeal (OPA) and Nasopharyngeal airways (NPA). In general, features of an ideal supraglottic airway include the ability to bypass the upper airway, produce low airway resistance, allow both positive pressure as well as spontaneous ventilation, protect the respiratory tract from gastric and nasal secretions, be easily inserted by even a nonspecialist, produce high first - time insertion rate, remain in place once in seated position, minimize risk of aspiration, and produce minimal side effects . </P> <P> A nasopharyngeal airway is a soft rubber or plastic tube that is passed through the nose and into the posterior pharynx . Nasopharyngeal airways are produced in various lengths and diameters to accommodate for gender and anatomical variations . Functionally, the device is gently inserted through a patient's nose after careful lubrication with a viscous lidocaine gel . Successful placement will facilitate spontaneous ventilation, masked ventilation, or machine assisted ventilation with a modified nasopharyngeal airway designed with special attachments at the proximal end . Patients generally tolerate NPAs very well . NPAs are preferred over OPAs when the patient's jaw is clenched or if the patient is semiconscious and cannot tolerate an OPA . NPAs, however, are generally not recommended if there is suspicion of a fracture to the base of the skull . In these circumstances, insertion of the NPA can cause neurological damage by entering the cranium during placement . There is no consensus, however, regarding the risk of neurological damage secondary to a basilar skull fracture compared to hypoxia due to insufficient airway management . Other complications of Nasopharyngeal airways use includes laryngospasm, epistaxis, vomiting, and tissue necrosis with prolonged use . </P>

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