Oxygenation is better when O₂ is administered in the pharynx rather than in the nostrils.

Comparison of oxygenation among different supplemental oxygen methods during flexible bronchoscopy in infants. Soong WJ, Lee YS, Tsao PC, Yang CF, Jeng MJ. J Chin Med Assoc, 2011.
“The Nasal Cannula group had the lowest SpO(2) at the pharynx (p 0.01) and carina (p 0.01). The (…) Nasopharyngeal Catheter groups had better SpO(2).”

Twice less oxygen is consumed when the latter is brought directly into the pharynx.

Nasopharyngeal oxygen in adult intensive care–lower flows and increased comfort. Eastwood GM1, Reeves JH, Cowie BS. Anaesth Intensive Care, 2004.
“Nasopharyngeal oxygen therapy consumed significantly less oxygen than mask administration (…) and was associated with significantly higher comfort than the mask (…).” 

In the non intubated patient, CO₂ sampling is more precise in the pharynx than in the nostrils.

Accuracy of End-tidal CO2 Measurement Through the Nose and Pharynx in Nonintubated Patients During Digital Subtraction Cerebral Angiography. Zhang C, Wang M, Wang R, Wang W. J Neurosurg Anesthesiol, 2012.
“Arterial to end-tidal CO2 pressure difference (Pa-ETCO2) in sampling through the nose was significantly greater than Pa-ETCO2 sampling through the pharynx.”

Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea.

Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study. Achar SK1, Pai AJ1, Shenoy UK1. Anesth Essays Res., 2014..
“Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea in a simulated prolonged difficult laryngoscopy.”

Capnography should be routinely used for non-intubated patients at risk for respiratory depression, in particular those receiving supplemental oxygen.

Current applications of capnography in non-intubated patients. Restrepo RD, Nuccio P, Spratt G, Waugh J. Expert Rev Respir Med, 2014.
“Capnography should be routinely used for non-intubated patients at risk for respiratory depression, in particular those receiving supplemental oxygen.”

Optimal oxygenation and airway patency are maintained using a nasal trumpet and oxygen supplementation.

Outpatient endoscopic retrograde cholangiopancreatography: Safety and efficacy of anesthetic management with a natural airway in 653 consecutive procedures. Goudra BG1, Singh PM, Sinha AC. Saudi J Anaesth. 2013.
“Optimal oxygenation and airway patency was maintained with high degree of success using simple (…) conduit devices (nasal (…) trumpet) with oxygen supplementation in all patients.”

Sedation in the outpatient setting induces the risk of ventilatory adverse events.

Airway management in the outpatient setting. Luba K, Apfelbaum JL, Cutter TW. Clin Plast Surg. 2013.
“Sedation at any level beyond minimal creates the risk of airway obstruction and ventilatory depression, which can result in irreversible brain injury or death within minutes.”

The use of nasopharyngeal airway is recommended in the frame of extubation.

Difficult Airway Society Guidelines for the management of tracheal extubation. Difficult Airway Society Extubation Guidelines Group, M. Popat et al. Anesthesia, 2012.
“Maintain airway patency with simple airway manoeuvers or (…) nasopharyngeal airway until the patient is fully awake.”

Capnography is a quick, low-cost method of enhancing patient safety with the potential to improve the clinician’s diagnostic power.

Capnography for the Nonintubated Patient in the Emergency Setting. Manifold CA, Davids N, Villers LC, Wampler DA. J Emerg Med. 2013.
“Capnographic changes provide valuable information in such processes as diabetic ketoacidosis, seizures, pulmonary embolism, and malignant hyperthermia.”

Nasopharyngeal oxygenation is a safe and comfortable alternative to face mask.

Nasopharyngeal oxygen (NPO) as a safe and comfortable alternative to face mask oxygen therapy. Eastwood GM1, Dennis MJ. Aust Crit Care, 2006.
“Nasopharyngeal oxygen therapy (…) should be considered (…) because of its effectiveness and improved comfort.”

The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway.

Awake Craniotomy: A New Airway Approach. Sivasankar C1, Schlichter RA, Baranov D, Kofke WA. Anesth Analg., 2016.
“In this case series, we describe the successful use (…) of bilateral nasopharyngeal airways in 90 patients undergoing awake craniotomies. The use of nasopharyngeal airways can ease the transition between the asleep and awake phases of the craniotomy without the need to stimulate the airway.”

Passive oxygen insufflation is superior to Bag-Valve-Mask Ventilation in Out-of-Hospital Cardiac Arrest.

Passive Oxygen Insufflation Is Superior to Bag-Valve-Mask Ventilation for Witnessed Ventricular Fibrillation Out-of-Hospital Cardiac Arrest. Bentley J. Bobrow et al., Annals of Emergency Medicine, 2009.
“Among adult, (…) out-of-hospital cardiac arrest (…) survival was higher for individuals receiving initial passive ventilation than those receiving initial Bag-Valve-Mask ventilation.”