Which airway adjunct is contraindicated if basal skull fracture is suspected?

• A. Oropharyngeal airway
• B. Endotracheal tube
• C. Nasopharyngeal airway
• D. Laryngeal mask airway

Answer: (C)

Suspecting a basal skull fracture means the nasal route should be avoided for airway devices. A nasopharyngeal airway passes through the nasal passages into the nasopharynx and can be driven through a fracture line into the cranial cavity, risking brain injury and infection. Because of this risk, the nasopharyngeal airway is contraindicated. If airway support is needed, use an oropharyngeal airway only in an unconscious patient without a gag reflex, or proceed to definitive airway control with endotracheal intubation. A laryngeal mask airway can be used as a temporary option when appropriate, avoiding the nasal route altogether.