NPA or OPA

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Sooo, quick question...

Would you use an NPA or an OPA on an unresponsive trauma patient if you think there may have been an injury to the spine?
Does it really matter which you use in this scenario?
 
lampnyter said:
I would go with OPA if there is suspected head injury
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Thank you!
That's what I thought, but then I wasn't sure if inserting an OPA would make the injury worse.
 
unresponsive!=lack of gag reflex?
 
If they're unresponsive then go with the OPA, if they don't accept (i.e. intact gag reflex) go with an NPA.
 
lampnyter said:
I would go with OPA if there is suspected head injury
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Risk of nasal airway use and head injury is significantly overstated, just be careful, if significant resistance is encountered then stop and try the other nostril.
 
emt.dan said:
Are we answering test questions for you?
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If he's actually taking a test right at this moment he shouldn't be able to access the internet to ask for help.

If he's not actually taking a test right at this moment then what difference does it make? Probably most of the questions that get asked here could potentially be test questions to somebody somewhere sometime.

And if you would refuse to answer a question if you suspect it's a test question, then all someone needs to do is answer "NO" if you ask if it's a test question, and I guess that makes everything better.
 
JJR512 said:
If he's not actually taking a test right at this moment then what difference does it make? Probably most of the questions that get asked here could potentially be test questions to somebody somewhere sometime.

And if you would refuse to answer a question if you suspect it's a test question, then all someone needs to do is answer "NO" if you ask if it's a test question, and I guess that makes everything better.
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The problem is that a lot of EMS training is pitifully bad. For example, failing to administer supplemental oxygen via NRB during the NREMT medical patient assessment station is a critical failure. Hence, the proper exam answer is, "Everyone gets oxygen." However, "everyone gets oxygen" is not good for routine treatment.
 
JPINFV said:
The problem is that a lot of EMS training is pitifully bad. For example, failing to administer supplemental oxygen via NRB during the NREMT medical patient assessment station is a critical failure. Hence, the proper exam answer is, "Everyone gets oxygen." However, "everyone gets oxygen" is not good for routine treatment.
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I see your point. If the purpose of asking if this was a test question was to ascertain whether a non-real-world answer is appropriate instead of an actual-real-world answer, then I apologize.
 
MrBrown said:
Risk of nasal airway use and head injury is significantly overstated, just be careful, if significant resistance is encountered then stop and try the other nostril.
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I agree. One of my lecturers was absolutely adamant that he'd never been able to find any evidence of an NPA braining someone with a basal skull fracture.

I've never looked myself, but I feel inclined to trust him.

Not having a patent airway: 100% fatal.
Risk of having a basal skull fracture which then allows the NPA to make its way into brain territory: <100%

I know which one I'd chose.
 
Melclin said:
I agree. One of my lecturers was absolutely adamant that he'd never been able to find any evidence of an NPA braining someone with a basal skull fracture.

I've never looked myself, but I feel inclined to trust him.

Not having a patent airway: 100% fatal.
Risk of having a basal skull fracture which then allows the NPA to make its way into brain territory: <100%

I know which one I'd chose.
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My instructor claims that he knows of a nurse that killed a patient doing this, if I remember correctly. Even so, we were still taught that head or face trauma does not necessarily contraindicate an NPA.
 
JPINFV said:
The problem is that a lot of EMS training is pitifully bad. For example, failing to administer supplemental oxygen via NRB during the NREMT medical patient assessment station is a critical failure. Hence, the proper exam answer is, "Everyone gets oxygen." However, "everyone gets oxygen" is not good for routine treatment.
Click to expand...

Agreed, it's like that discussion a couple weeks ago where we tell Basics to ALWAYS dispatch ALS, when in fact we should be teaching them to do a very thorough assessment and really think about whether or not that call needs an ALS unit...but that's another discussion completely.
 
always OPA unless a suspected skull fractuce. OPA is a vital piece of equipment to be able to secure the airway and not allow the tongue to occlude it.
 
lampnyter said:
Umm... No.
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haha agreed. No. If my patient is unresponsive. And has snoring respirations then yes OPA all the way. I don't think you should rely on it all the time though. It's just an adjunct not a cure all.

And if I suspect a skull fracture or other facial trauma I'm not gonna use an NPA. Just in case.

On another note...

fast65 said:
Agreed, it's like that discussion a couple weeks ago where we tell Basics to ALWAYS dispatch ALS, when in fact we should be teaching them to do a very thorough assessment and really think about whether or not that call needs an ALS unit...but that's another discussion completely.
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I completely agree with this. I just finished basic and every scenario was "ok at this time I am going to call ALS or possibly set up an intercept"

One was a broken ankle and I said I could handle it and I wouldn't call ALS. And I was marked wrong. Because ALS could give pain meds.

SO from then on it was always ALS and NRB for every scenario.
 
lampnyter said:
Umm... No.
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If you don't think every patient that you are bagging requires an OPA you might need to go back to EMT-basic school. That is the most basic skill, and can make a different between a adequate and inadequate ventilation.
 
bluefinmedic said:
If you don't think every patient that you are bagging requires an OPA you might need to go back to EMT-basic school. That is the most basic skill, and can make a different between a adequate and inadequate ventilation.
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You keep saying EVERY pt. That's where I disagree.

Contraindications?

Better choices?

Patient unconscious but throwing up or having a lot of salivation u need to keep suctioning.

There could be better choices esp if you are a medic like your sn implies.
 
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