Why should the nasopharyngeal airway not to be used if there is evidence of clear fluid from nose or ears?

The presence of clear fluid from the nose or ears can indicate a cerebrospinal fluid (CSF) leak. CSF is the fluid that bathes the brain and spinal cord. A leak can occur due to a skull fracture or other trauma.

If a nasopharyngeal airway is inserted in the presence of a CSF leak, it can increase the pressure in the skull and cause the leak to worsen. This can lead to serious complications, including brain damage and death.

For this reason, it is important to avoid using a nasopharyngeal airway if there is any evidence of clear fluid from the nose or ears. If you are unsure whether or not there is a CSF leak, it is best to err on the side of caution and not use a nasopharyngeal airway.