A nasopharyngeal airway is an adjunct used to relieve airway obstruction due to tongue relaxation in an unconscious or semiconscious patient. It is considered a safe procedure in patients without massive facial trauma or basilar skull fracture. This is a report of a healthy patient undergoing procedural sedation who sustained a middle turbinectomy upon placement of a nasal trumpet to assist ventilation. He subsequently developed severe epistaxis that resolved only after multiple attempts of packing both by the emergency physician as well as the otolaryngology service. It is to be hoped that this will increase awareness among emergency physicians of this unusual complication.