In suspected basilar skull fracture, which airway device should be avoided?

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Multiple Choice

In suspected basilar skull fracture, which airway device should be avoided?

In suspected basilar skull fracture, avoid any device that goes through the nasal passages because the nasal route can breach the fractured skull base and create a direct path into the cranial cavity. A nasopharyngeal airway is inserted through the nose into the nasopharynx, so if a base of skull fracture is present, it can penetrate into the brain or meninges, risking brain injury, meningitis, or CSF leak. That risk is why this device is not used in these cases. Other airway tools don’t share that same nasal-entry risk. A bag-valve-mask with oxygen maintains ventilation without entering the cranial vault. An oropharyngeal airway can be used in an unresponsive patient to keep the airway open by preventing the tongue from choking the airway. An endotracheal tube provides a definitive airway when more secure ventilation is needed.

In suspected basilar skull fracture, avoid any device that goes through the nasal passages because the nasal route can breach the fractured skull base and create a direct path into the cranial cavity. A nasopharyngeal airway is inserted through the nose into the nasopharynx, so if a base of skull fracture is present, it can penetrate into the brain or meninges, risking brain injury, meningitis, or CSF leak. That risk is why this device is not used in these cases.

Other airway tools don’t share that same nasal-entry risk. A bag-valve-mask with oxygen maintains ventilation without entering the cranial vault. An oropharyngeal airway can be used in an unresponsive patient to keep the airway open by preventing the tongue from choking the airway. An endotracheal tube provides a definitive airway when more secure ventilation is needed.

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