Remember that If you need these then the patient will probably not have a gag reflex. Using both is not a bad thing, but the OPA should always suffice. In some cases in very difficult airways people are using whatever they can, to ventilate. OPA, NPA, with a BVM and someone also doing jaw thrust. I personally don't NPA's. Having said this, in a difficult situation use what you can, do everything you can, don't limit yourself to what you have been taught, think laterally.
I would like to point out that there ARE times where a conscious patient will require an OPA, and the majority of these patients WILL have a gag reflex.
I'm interested in the comment. I would say that there are very FEW indications for a CONSCIOUS patient to need one. If they are conscious, they are by definition breathing spontaneously, with intact reflexes; oxygen mask should suffice. Which specific patients would you use them on?
But by textbook example: if a non-ALOC pt requires airway management (in the form of NPA), but has an obstructed nasal cavity or nostrils, we are to OPA. This is common in facial trauma. I heard about a guy who fell out car and went face first into a parked vehicle and crushed his nose and was experiencing SOB. He was non-ALOC and needed an airway adjunct. Instead of touching the crushed nose, responding EMS used an OPA.
Great Q's. If the patient has no ALOC, then simple mask should suffice. A blocked nose doesn't mean blocked oropharyngeal passage. Crushed nose should rightly not be touched, as it will promote bleeding. Also, potential base of skull injury, wrong placement of OPA will see you potentially inserting into the brain. In the example, I wonder if the patient really had no ALOC as he tolerated an OPA- that doesn't make sense. OPA with gag = vomiting, and raised ICP- bad. Textbook vs reality. Enjoy!
I know it doesn't mean OPA is blocked. That's why we're told to go OPA if there's nasal blockage when an adjunct is needed or advised.
OPA into the brain? I've heard of NPA's running that risk, but not OPA's...
I wasn't there on that call so I can't 100% confirm, but I heard over the radio requesting an ALS unit and had wanted confirmation of an OPA in place of an NPA on the non-ALOC patient. They got the 10-4.
Definitely prehospital case is a case-by-case thing.
theres no need for intibation with BOTH NPA and OPA, you only need one, dumbass
munk3ypooh22 9 months ago
Strictly speaking, they aren't both needed at once. In most cases the oropharyngeal will suffice.
However there may be situations when both are need to improve the oxygenation of patients.
somahealth 3 years ago
I've never been taught to do both, ever.
OPA most commonly, NPA if patient has strong gag reflex or OPA is obstructed in some way.
nomofica0 2 years ago
Remember that If you need these then the patient will probably not have a gag reflex. Using both is not a bad thing, but the OPA should always suffice. In some cases in very difficult airways people are using whatever they can, to ventilate. OPA, NPA, with a BVM and someone also doing jaw thrust. I personally don't NPA's. Having said this, in a difficult situation use what you can, do everything you can, don't limit yourself to what you have been taught, think laterally.
somahealth 2 years ago
I would like to point out that there ARE times where a conscious patient will require an OPA, and the majority of these patients WILL have a gag reflex.
nomofica0 2 years ago
I'm interested in the comment. I would say that there are very FEW indications for a CONSCIOUS patient to need one. If they are conscious, they are by definition breathing spontaneously, with intact reflexes; oxygen mask should suffice. Which specific patients would you use them on?
somahealth 2 years ago
But by textbook example: if a non-ALOC pt requires airway management (in the form of NPA), but has an obstructed nasal cavity or nostrils, we are to OPA. This is common in facial trauma. I heard about a guy who fell out car and went face first into a parked vehicle and crushed his nose and was experiencing SOB. He was non-ALOC and needed an airway adjunct. Instead of touching the crushed nose, responding EMS used an OPA.
nomofica0 2 years ago
Great Q's. If the patient has no ALOC, then simple mask should suffice. A blocked nose doesn't mean blocked oropharyngeal passage. Crushed nose should rightly not be touched, as it will promote bleeding. Also, potential base of skull injury, wrong placement of OPA will see you potentially inserting into the brain. In the example, I wonder if the patient really had no ALOC as he tolerated an OPA- that doesn't make sense. OPA with gag = vomiting, and raised ICP- bad. Textbook vs reality. Enjoy!
somahealth 2 years ago
I know it doesn't mean OPA is blocked. That's why we're told to go OPA if there's nasal blockage when an adjunct is needed or advised.
OPA into the brain? I've heard of NPA's running that risk, but not OPA's...
I wasn't there on that call so I can't 100% confirm, but I heard over the radio requesting an ALS unit and had wanted confirmation of an OPA in place of an NPA on the non-ALOC patient. They got the 10-4.
Definitely prehospital case is a case-by-case thing.
nomofica0 2 years ago
Sorry , wrong word, meant NPA into brain. Although very rare(and I teach its use) has been described. Bad look on the CT.
Each call is as it is. Great to share info with you. You guys do an incredible job!
10-4
somahealth 2 years ago
Thanks!
nomofica0 2 years ago
why both oropharyngeal and nasopharyngeal airways?
Can482 3 years ago