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I understand the logic with passive oxygenation since no one is actively managing the airway, but I still wonder how effective three adjuncts actually are. As said, it's not like any of them negate the need to open airway with proper positioning when you're actively ventilating someone.If one is good, two is better, and three fills up all the holes?
In all seriousness, if I'm running a BLS arrest with enough personnel, and there's good ventilation with BVM + OPAwith supplemental O2, good CPR in progress, and an AED attached, I don't see why *not* to stick in an extra NPA...
If it's respiratory distress, but the patient is conscious and being BVM'ed, why not double up on the NPAs, assuming they're tolerated? (I realize "why not" isn't necessarily evidence based -- on the other hand, I can't imagine that any harm would occur...)