Airway adjuncts on resus.com.au

Dr Peter Kas of Soma Health demonstrates basic advanced airway techniques at www.resus.com.au Share them with others.

Category:

Education

Tags:

• Airway
• bag
• ventilation
• oral
• airway
• orotracheal
• nasopharyngeal
• emergency
• Medicine

[munk3ypooh22]

theres no need for intibation with BOTH NPA and OPA, you only need one, dumbass

[nomofica0]

Thanks!

[somahealth]

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

[nomofica0]

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.

[somahealth]

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!

[nomofica0]

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.

[somahealth]

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?

[nomofica0]

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.

[somahealth]

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.

[nomofica0]

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.