NPA Usage.

EGTA.

Now those were the good times, intubation and lavage in one handy, dandy useless tool. :)
 
rwik123 said:
Isn't any facial trauma a contradiction for NPAs?
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Nope. Basal skull fracture. A lot of providers operate on the safe side and avoid NPAs on anyone with facial/head trauma in general, though.
 
Battle sign (retroauricular ecchymosis) and Racoon Eyes (periorbital ecchymosis) are very late signs and will usually not be present during the pre-hospital phase of care so I would not rely on those signs too much.
 
^
How many ambulances carry filter paper?
 
Lifeguards For Life said:
How would you know if they have a basilar skull fracture?
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Clinical suspicion.


spike91 said:
You can improvise.
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If you think that a patient might have a BSF and has fluid leaking out of their nose and ears, you could bugger around and find something that looks like filter paper and try to elicit a poorly understood and often unclear clinical sign and end up exactly where you started - with a suspected BSF. Or you could take them to someone who can make the diagnosis.
 
spike91 said:
halo test. also any nasal/oral leakage.
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the presence of a positive halo sign is not exclusive to CSF and can lead to false-positive results.

I was only asking because you told that other bloke "no" on the facial trauma..
LondonMedic said:
Clinical suspicion.
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So basically extensive facial trauma:P

Hey Doc. leave some q's and a's for the rooks:P
 
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What really sucked about the EOA was when it came apart when you were doing CPR.

Another useless EMS device.
 
You can also test the suspected CSF with a glucometer.... if mg/dl are half of the patients BG level its considered positive. Again, a time consuming task that likely won't alter your treatment but thought I would throw that out there.

(not sure what the specificity of this test is)
 
18G said:
You can also test the suspected CSF with a glucometer.... if mg/dl are half of the patients BG level its considered positive. Again, a time consuming task that likely won't alter your treatment but thought I would throw that out there.

(not sure what the specificity of this test is)
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I think it is relatively low. We were taught this method by one instructor who later told us not to do it.

CSF should be about 60-80% the concentration of the glucose in the blood. If you had some snot mixed with blood, it could look like CSF, and this mixture could easily test in that 60-80 percent range.

the halo test can be viewed as 'conformation' of what you already know, at best. However if the halo test/glucose test is negative but other sign/symptoms are present, I would not rule out CSF leakage
We had a good thread on testing for CSF with a glucometer here back in (December?).
 
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Personally I would not have used an NPA. O2 wasn't necessary but wont hurt if only on for a short time.

Only time I've used an NPA on a seizure patient she was full tonic/clonic x 3 minutes and wasn't adequately breathing on her own. Had to bad her. Good job on your part.
 
I love the NPA, its indicated in more of my patients then the OPA, most have a gag reflex and my first rule is don't puke on me. Its also the only airway adjunct we have, and I love asking for lube on calls, I get funny looks
 
bigalow said:
Only time I've used an NPA on a seizure patient she was full tonic/clonic x 3 minutes and wasn't adequately breathing on her own. Had to bad her. Good job on your part.
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I'm assuming you're meaning "bag". A small pet peeve of mine. Grocers "bag"...
 
Sam Adams said:
I'm assuming you're meaning "bag". A small pet peeve of mine. Grocers "bag"...
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Do you also get annoyed when someone say 'tube' instead of intubate or 'stick' instead of IV Cannulation?
 
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