If you carry a NPA (Nasal Pharygneal Airway), what size do you carry?

[The Bubba Effect]

I have been reading about NPA's and their use. It is my understanding that there are different sizes.

Chinook Medical carries four sizes of NPA: 28, 30, 32, 34.

If you carry one (or more) what size(s) do you carry?

Also, If you know how to use them and do not carry them, why not?

Thanks!

 

[rhino]

I have been reading about NPA's and their use. It is my understanding that there are different sizes.

Chinook Medical carries four sizes of NPA: 28, 30, 32, 34.

If you carry one (or more) what size(s) do you carry?

Also, If you know how to use them and do not carry them, why not?

Thanks!

I carry the size that is a best guess to fit me, 30 French.

You should carry the size that fits you, after you learn why, when, and how to use it.

 

[Loco179]

NP airways really are of limited use normally. For a layperson they are of no use. There are tons of contraindications. Not only that but the amount of tissue damage you can cause to a airway. Let me explain why they are a bad idea for a non-professional.

Look at where the airway actually sits. It provides no real airway to the important area. Not only that, you ARE going to cause a gag reflex. So now you have a real airway problem. Its a small flexible tube, inserted though a soft tissue area. So actually your causing more harm than good.

So now you have created a life threatening situation though several different factors. Your patient could have a head injury, you could shift something in really a area you do not need to breath. You have caused soft tissue injury, shoving a tube though someones nasal airway does cause damage. You have caused a gag reflex, this leads to aspiration. That means now you have a huge problem. You have inserted a device that really has limited airway use.

Now there is hope! The most effective way to secure a airway is though basic noninvasive skills.

[video=youtube;Df72yPYMAXo]http://www.youtube.com/watch?v=Df72yPYMAXo[/video]

Modified Jaw Thrust

[video=youtube;kxfY-f7EV8M]http://www.youtube.com/watch?v=kxfY-f7EV8M[/video]

Head Tilt Chin Lift

So I just saved you some cash and showed you something better than your NPA. There are uses for them, but not for the layperson. They are very invasive for little to no benefit for your use.

 

[The Bubba Effect]

Thanks for the input guys! I will watch the videos when I get home.

Keep the input coming!

 

[docapos]

NP airways really are of limited use normally. For a layperson they are of no use. There are tons of contraindications. Not only that but the amount of tissue damage you can cause to a airway. Let me explain why they are a bad idea for a non-professional look at where the airway actually sits. It provides no real airway to the important area. Not only that, you ARE going to cause a gag reflex. So now you have a real airway problem. Its a small flexible tube, inserted though a soft tissue area. So actually your causing more harm than good.

I have to disagree, an NPA can be a valuable airway management tool(there is a reason they are on every mandatory ambulance gear list) as with all things training is required but you can't completely dismiss it. Properly fitted it will protect an airway in an unconscious patient and will NOT cause a gag reflex in the vast majority of people.

I carry the size that is a best guess to fit me, 30 French.

You should carry the size that fits you, after you learn why, when, and how to use it.

May I ask what your thought process is on carrying only the size that fits you?

 

[Double T]

NP airways really are of limited use normally. For a layperson they are of no use. There are tons of contraindications. Not only that but the amount of tissue damage you can cause to a airway. Let me explain why they are a bad idea for a non-professional.

Look at where the airway actually sits. It provides no real airway to the important area. Not only that, you ARE going to cause a gag reflex. So now you have a real airway problem. Its a small flexible tube, inserted though a soft tissue area. So actually your causing more harm than good.

So now you have created a life threatening situation though several different factors. Your patient could have a head injury, you could shift something in really a area you do not need to breath. You have caused soft tissue injury, shoving a tube though someones nasal airway does cause damage. You have caused a gag reflex, this leads to aspiration. That means now you have a huge problem. You have inserted a device that really has limited airway use.

Now there is hope! The most effective way to secure a airway is though basic noninvasive skills.

[video=youtube;Df72yPYMAXo]http://www.youtube.com/watch?v=Df72yPYMAXo[/video]

Modified Jaw Thrust

[video=youtube;kxfY-f7EV8M]http://www.youtube.com/watch?v=kxfY-f7EV8M[/video]

Head Tilt Chin Lift

So I just saved you some cash and showed you something better than your NPA. There are uses for them, but not for the layperson. They are very invasive for little to no benefit for your use.

I see no reason that you could not use one. yes, there are contraindications, but that is with most all medical equipment. Since I can't perform a tracheotomy legally, this is the next best thing to that.

 

[jwhitaker45]

May I ask what your thought process is on carrying only the size that fits you?

agreed with the question. I carry a size for me, my wife, and kids. But I carry one for me because my wife knows how to use it. But it's pointless to only carry for you, because you aren't going to be protecting your own airway. Carry for the daily situations you live and work. I suggest to all child care givers to carry 3 different child sizes as well as one for themselves.

 

[docapos]

agreed with the question. I carry a size for me, my wife, and kids. But I carry one for me because my wife knows how to use it. But it's pointless to only carry for you, because you aren't going to be protecting your own airway. Carry for the daily situations you live and work. I suggest to all child care givers to carry 3 different child sizes as well as one for themselves.

Awesome job in your wife being trained as well, I unfortunately have not been able to convince mine yet.

 

[Scuba591]

It used to be that the size needed was determined by the length from the lower tip of the ear lobe to the tip of the mouth on the same side of the face. Is that still the case?

 

[rhino]

May I ask what your thought process is on carrying only the size that fits you?

I was answering the question about what I carry, not what I have available in a bigger kit I keep in my house or my vehicle. I carry a lot of stuff on my person every day, and I've chosen what medical gear I carry very carefully.

My blowout kit is for treating me. Secondary use is for use on others. Of course I can't use a nasopharyngeal airway on myself, but a significant number of the people with whom I associate on a regular basis 1) know where I have it, and 2) know why, when, and how to use it. And there are a few that I actually trade info about what we're carrying and where when we meet (like when we're squadded together for an IDPA match). They tell me where they have their blowout kit and I do the same.

My kit is exactly what Doc Gunn recommends in his Tactical Treatment of Gunshot Wounds course (6" IBD, NP airway, 14ga needle catheter, and two wraps of tape around it) plus a tourniquet. This includes his recommendation that my NP airway be a 30 French because that's what he estimated would fit me.

I'm not a medical professional. If I were, I might be inclined to carry more gear intended for use on other people, but then I would also have a reason for carrying more medical gear on my person.

 

[Double T]

It used to be that the size needed was determined by the length from the lower tip of the ear lobe to the tip of the mouth on the same side of the face. Is that still the case?

No idea, but I know that's 1/2 of the way to figure out NG feeding tube insertion length so I imagine that's a good indicator and makes perfect sense to this nurse

 

[cerebus85]

Having had one put put in before I can tell you it's not pleasant if you have any injuries to the face prior and they don't know it's going to be painfull and dangerous. If it's under stress it's going to be even worse. Just make sure you have looked at all avenues and are actually trained

 

[docapos]

I was answering the question about what I carry, not what I have available in a bigger kit I keep in my house or my vehicle. I carry a lot of stuff on my person every day, and I've chosen what medical gear I carry very carefully.

My blowout kit is for treating me. Secondary use is for use on others. Of course I can't use a nasopharyngeal airway on myself, but a significant number of the people with whom I associate on a regular basis 1) know where I have it, and 2) know why, when, and how to use it. And there are a few that I actually trade info about what we're carrying and where when we meet (like when we're squadded together for an IDPA match). They tell me where they have their blowout kit and I do the same.

My kit is exactly what Doc Gunn recommends in his Tactical Treatment of Gunshot Wounds course (6" IBD, NP airway, 14ga needle catheter, and two wraps of tape around it) plus a tourniquet. This includes his recommendation that my NP airway be a 30 French because that's what he estimated would fit me.

I'm not a medical professional. If I were, I might be inclined to carry more gear intended for use on other people, but then I would also have a reason for carrying more medical gear on my person.

It was really just a curiosity, that set up does sound good to have as an immediately available blow out kit.

 

[docapos]

It used to be that the size needed was determined by the length from the lower tip of the ear lobe to the tip of the mouth on the same side of the face. Is that still the case?

You're thinking OPA(device placed in the mouth). Here is a quick article that is packed with information, as always all information is for personal knowledge and is not a substitute for professional training. http://theemtspot.com/2009/12/08/the-art-of-the-nasopharyngeal-airway/

 

[rhino]

It was really just a curiosity, that set up does sound good to have as an immediately available blow out kit.

Heh, 'salright. I was answering the other person who seconded your question too. I thought I'd be complete in my answer.

 

[iamaclone45]

I have never really understood why the layperson always wants to carry "advanced" medical gear with them.

If you want to make a difference, carry something to stop bleeding and make sure you know how to perform quality CPR. If someone goes into cardiac arrest, start compressions and forget the airway. Oxygen remains in their blood, it just needs circulated. Let the professionals manage the airway.

I have almost 10 years of EMS experience in a busy system.

I'm not sure how I would react if I arrived on a scene where a lay person has placed an NP (or performed any advanced skill for that matter) but I'm going to guess I would chuckle, remove the NP, and then request your information for the patient care report so the lawyer can sue the right person for any damages or negative outcomes the placement or skill may have caused.

 

[cerebus85]

I'm going to guess I would chuckle, remove the NP, and then request your information for the patient care report so the lawyer can sue the right person for any damages or negative outcomes the placement or skill may have caused.[/QUOTE]



this is is why the needle D and the np stay at home.

 

[The Bubba Effect]

This is a fascinating conversation.

I don't carry one and I don't know when they would be used. This thread is being most educational.

What's a "needle D"?

 

[cerebus85]

Needle decompression.

 

[shades171]

I agree with iamaclone45 and Loco179 about not using it unless you've been trained. However, one reason to carry some equipment (for grid -down scenario) would be that in the group you are with you might have someone that has been trained to use it. Just my opinion --- (22yrs as EMT in which 15 as a Medic).


I only carry enough equipment for me and my family. But in a grid down environment (EMP, natural disaster, whatever) I would be willing to help if I had enough supplies. However, don't think that an individual would have enough supplies for the entire group. If everyone has there own supplies that would be more beneficial.

Remember, I'm speaking of grid down. Most situations just call 911 and leave it to the trained providers.