NPAs and Nasal Intubation in Peds

[LucidResq]

There's some discussion going around my state's EMS listserv about the use of NPAs and nasal intubation in pediatric patients. Some are saying that NPA use in peds is discouraged and nasal intubation is strongly discouraged, others are saying that one shouldn't hesitate to use an NPA if necessary.

Thoughts?

 

[Code 3]

Our protocols state no NPA in < 1 years of age. Here's some good info from the text:

In very young patients, the NPA is so small that it is easily obstructed by secretions and other upper airway substances. Children may have large adenoids which will make insertion of the NPA very difficult. This may also lead to injury and bleeding. Even if insertion is possible, the large adenoids may compress the NPA and increase the resistance in the airway. This may make the use of a NPA in the very young ineffective.

-Brady Prehospital Emergency Care 7th Ed. Pg. 111-112

 

[Ridryder911]

Would not even considered nasal intubation for several reasons. First the anatomy is definitely would be near impossible as well as the ETT is pliable one would see that it would be near impossible to manipulate.

R/r 911