NPA question for you ems and rn and medical folk

Love2shoot

Stay Gray
Joined
Jun 9, 2017
Messages
1,157
Location
Low & Left
Rating - 100%
4   0   0
So Im in the middle of my emt certification (strictly for personal knowledge and curiosity not for a job) and Im curious why do gun culture types who put together trauma kits always include and kind of make a big deal of having an NPA? If someone is shot, why would they lose their airway requiring one? Other than the tongue blocking it, I wasnt understanding the essential need for it in a ifak. Any thoughts or knowledge appreciated.
 
I personally don't have one in my personal kit. In my home kit I have a multitude of intubation supplies because my wife is a respiratory therapist. But if it was some huge SHTF scenario I don't know how much good intubating someone would do because in all likelihood we wouldn't have access to a ventilator anyway.
 
  • Like
Reactions: JT
There are times when an NPA can be used. If a patient is unconscious but still has a gag reflex is one. In some persons, when they are unconscious the tongue can relax and block the airway. Also, if a person has mouth or jaw trauma it is useful. You also have to position person so blood will move out and not in the throat. It is not as effective as intubating, but that is a paramedic skill. Anaphylactic shock from bee stings or something else is where it could buy you some time also. If you have to perform CPR it is better than nothing especially if you have BVM. In EMT, airway is number one, followed breathing and circulation. It's one of those things where you might not ever need it, but if you do and have it, it can make all the difference. If you don't, well, go to the next patient because it is probably game over.

Sent from my SM-G920V using Tapatalk
 
There are times when an NPA can be used. If a patient is unconscious but still has a gag reflex is one. In some persons, when they are unconscious the tongue can relax and block the airway. Also, if a person has mouth or jaw trauma it is useful. You also have to position person so blood will move out and not in the throat. It is not as effective as intubating, but that is a paramedic skill. Anaphylactic shock from bee stings or something else is where it could buy you some time also. If you have to perform CPR it is better than nothing especially if you have BVM. In EMT, airway is number one, followed breathing and circulation. It's one of those things where you might not ever need it, but if you do and have it, it can make all the difference. If you don't, well, go to the next patient because it is probably game over.

Sent from my SM-G920V using Tapatalk
ABC's....right on

Sent from notthedroidyourelookingfor
 
Thanks guys for the responses. Thats exactly what weve learned as well ABC/CAB just was curious how an NPA would play into a scenario where its hey someone got shot on the range. I guess if they lost conciousness and then the tongue began to block the airway?. As for keeping it in a medical response bag I completely see the need for it.. Thanks again.
 
Just remember, do no more harm...................
 
Never use an NPA with any kind of head trauma. If there’s damage to the soft pallet you can stick it through it. As for using an NPA for a gsw they work great for the ones who have a gag reflex and aren’t to the point where you can king them. I’ve used more NPA’s on heroine addicts than anything thing else. An NPA and some narcan fixes em right up.


Sent from my iPhone using Tapatalk
 
Yep, managing the unconscious patient's airway. You guys got it. Sometimes the positioning of a patient during an extraction/off a battlefield will not allow for great airway management.
 
Folks you got to realize an NpA is s short term fix. It will keep an airway open but in the prehospital setting it alone will not save a person’s life. It is more of s stop gap measure to buy some time to get them to the definitive care they need aka a surgeon and some blood.
 
Is it also always the case that if you are inserting an npa you are always ventilating them as well?

I’ve seen them inserted and never bagged but I’d say most of the time they get bagged bc your not going to put one in just for s&g.


Sent from my iPhone using Tapatalk
 
I suspect another part of the reason npas are the standard airway device for a small ifak is simply that they are small and flexible and you can use one size for the majority of patients. Much easier to stuff one npa into a pouch than a kit of 3-5 opas. Less weight, too.
 
@Love2shoot

NPAs are standard fare in IFAKs because a) anyone can use it, and b) very little downside (minimal practice, minimal competency, minimal risk). Even to @Zbizzle911 point, the relative probability of causing more damage is extremely low (but it is there). We had to put them in each other in training.

Creating an airway is separate from ventilation, but if you put in an airway, you must be prepare to ventilate (mouth mask, BVM, whatevs). To @Sneakymedic point, it is usually a 'placeholder' for/during extrication.
 
Yep, all makes alot of sense. I think my hardest part understanding was how it goes from "oh crap im shot" to "now im losing my airway"
 
Yep, all makes alot of sense. I think my hardest part understanding was how it goes from "oh crap im shot" to "now im losing my airway"

If you lose enough blood your BP is going to tank, and you'll lose consciousness, and your tongue will occlude your airway. That's the most likely scenario.
 
If you lose enough blood your BP is going to tank, and you'll lose consciousness, and your tongue will occlude your airway. That's the most likely scenario.

That is the answer I was looking for, thank you! Funny enough I have my practice scopes tonight to pass before moving on in the EMT program, should be interesting well see how that goes.
 
So Im in the middle of my emt certification (strictly for personal knowledge and curiosity not for a job) and Im curious why do gun culture types who put together trauma kits always include and kind of make a big deal of having an NPA? If someone is shot, why would they lose their airway requiring one? Other than the tongue blocking it, I wasnt understanding the essential need for it in a ifak. Any thoughts or knowledge appreciated.

You've gotten some pretty good answers, I'd say. :)

I personally wasn't aware that "gun people" did that, and I could argue against "essential need", but it's not a bfd one way or another in an ifak, so ...

In all my years of emergency response and training responders, I never used one nor saw one used out in the field. But the diversity of others' experience differs from mine. We had a full set in the jump bag at all times (but we carried a monster jump bag so we had pretty much a full set of everything).
 
My 2 cents.

I have put in a nasal trumpet exactly 1 time and seen one put in once more in the hospital setting.
I put in one to assist with NT suctioning a patient who had no ability to spontaneously cough.
The one I witnessed was a strange situation. Guy was in respiratory failure, Doc had to intubate nasally due to some sort of mass, used an NPA to facilitate.
I've never seen a patient come in EMS with an NPA. But then, they'll just skip that and throw in a King, LMA, or just intubate.

I have seen and used OPA's with ambu bag to keep an airway open and make ventilation easier. If you're worried about the tongue obstructing the airway, this will do the trick if the tongue hasn't already swelled up or blocked the airway in such a manner that you can't shove it out of the way.

What's bad is someone who doesn't know what they're doing trying to jam one in someone's nare. Most of these people on the internet putting together "trauma kits" fall into that category.

I keep a Mac blade and a couple tubes in my stuff, just in case. I doubt I'll ever use one. If you can move air by begging a patient, and they aren't in danger of losing their airway, get them somewhere that an ET intubation isn't going to be risky and traumatic. You can bag a patient for hours and hours and do little harm except some gastric insufflation.
 
We use the hell out of them on diabetics (hypo) and heroin ODs when either has snoring respirations...they work pretty damned good.
 
Back
Top Bottom