Jordan is an EMR who is working hard to stabilize a patient in respiratory failure. The patient is still conscious, so Jordan decides that she must use an NPA to keep the patient’s airway secure. Jordan slides the NPA gently into one of the patient’s nostrils, angling the curve of the NPA to match the angle of the airway. She does not feel any resistance, but as Jordan attempts to get the NPA into position, the patient’s nose begins to bleed heavily. What is MOST likely the reason for this sudden bleeding?

Jordan has pierced an artery or vein in the patient’s sinus cavity.

Jordan has forgotten to use lubrication on the NPA when she inserted it.

The patient has a brain injury that Jordan does not know about.

The NPA is not in the correct position in the patient’s nasal cavity.

When inserting a Nasopharyngeal Airway (NPA), it is crucial to be cautious as the nasal passages contain blood vessels that can be easily damaged. In this scenario, the sudden bleeding suggests that Jordan may have inadvertently punctured an artery or vein in the patient's sinus cavity while attempting to position the NPA. This can lead to a nosebleed, which is a common complication when inserting medical devices into the nasal passages.

It's essential for medical professionals like Jordan to be trained in proper NPA insertion techniques to minimize the risk of complications such as bleeding. Using lubrication on the NPA can help reduce friction during insertion, but the main concern in this case is the potential injury to the blood vessels in the sinus cavity.

In conclusion, the most likely reason for the sudden bleeding is the accidental piercing of an artery or vein in the patient's sinus cavity during NPA insertion. Jordan should carefully assess the situation, control the bleeding, and seek appropriate medical assistance to address the issue effectively.