Which airway adjunct should not be used in a patient with a suspected skull fracture?

In the context of managing a patient with a suspected skull fracture, the use of a nasopharyngeal airway is advised against due to the risk of further injury. A nasopharyngeal airway is inserted through the nose and into the pharynx, and in cases of skull fractures, especially those involving the base of the skull, there is a potential for penetrating into the cranial cavity if the nasal passages are disrupted. This could lead to serious complications, including intracranial injury or infection.

On the other hand, oropharyngeal airways, while useful for maintaining airway patency by preventing the tongue from obstructing the airway, do not pose the same risk of penetrating injuries as nasopharyngeal airways do in the context of skull fractures. Additionally, endotracheal tubes and bag-valve masks are techniques that can also be safely utilized to manage the airway, albeit with consideration for the overall stability and condition of the patient.

Choosing the appropriate airway adjunct is critical to providing safe and effective emergency care, particularly in patients with potential life-threatening injuries like those involving the skull.