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Krenta
Location: Saint Paul, MN Total Likes: 8 likes
Nope, wasn't me.
| | | NPA sizes? WTF? < on 1/21/2005 7:25 AM > | Reply with Quote
| | | Okay, when I did the first-responder training way back when, the instructor was really big on nasopharyngeal airways - NPAs - for securing airways, because any idiot and their mother can insert one successfully, as opposed to, um, the oral tube airway (OPA?), and they stay "in" a lot better than the hard plastic (Berman?) airways. Now, he only touched on them really briefly, because we were training to be first responders, damnit, not EMT-Bs, and NPAs are kind of "above and beyond". That said, I carry far more medical and first-aid supplies on me when exploring than is probably necessary, because, well, shit happens. I've got a set of the hard plastic airways, but I was looking to replace them with NPAs. Only thing is, I'm way confused about the sizing on these puppies. "20fr" to "32fr"? What the hell's that all about. I don't recall the ones we were taught on being marked in any way; we were taught to pick the one just smaller than the patient's little finger, and use that. Assuming "20fr" is the smallest, I could probably go with a couple of those, but I have no clue if this is moderately sized, or pediatrically-sized, or what. I've searched Google, but that wasn't much help, so if any of you folks have got a clue as to what the fuck wierd-ass metric sizing system NPAs use, or a recommendation as to what size(s) is(are) (a) safe bet for average adults... lemme know. On an unrelated note, since this is a really dead forum, self-adherent gauze is proof the Gods love us and want us to be happy.
| Have Speed Graphic, Will Travel. |
| Therrin This member has been banned. See the banlist for more information.
Location: North of Chicago, IL Gender: Male Total Likes: 279 likes
*Therrin puts on the penguin-suit
| | | | Re: NPA sizes? WTF? < Reply # 8 on 3/13/2010 1:55 AM > | Reply with Quote
| | | Yeah I'm not sure about the specific sizing by numbers, we just size them manually based on the person they've got to fit. You're missing some info about OPA's and NPA's though. One doesnt "replace" the other, they're for different uses and situations. As mentioned, you wouldnt use an OPA in a conscious patient, they're ONLY for use in unconscious patients. And if a patient had trauma to the nasal passages of some sort, you wouldnt use an NPA anyway, but if they had nasal trauma and were unconscious you could still use an OPA. Likewise, for a patient with oral trauma who was unconscious you still wouldnt necessarily use an OPA, because an NPA might be more appropriate. They're only adjunct airways, they dont replace the use of an ET or similar device, they only assist in opening an airway when using the normal BVM cup isnt getting air to the lungs for some reason. And while NPA's are more convenient and "easier" to use, they can still cause trauma on their own if you arent carefull about inserting them, or if you dont lube them up right first. I've had an NPA stuck in (just for fun, at the ER) and they feel really flippin wierd, but they provide a great passage for air flow through the nasal passages, thats surely true.
| Give a person a match and they'll be warm for a minute, but light them on fire and they'll be warm for the rest of their life. =) |
| PositivePressure
Location: High and low where most don't go Gender: Male Total Likes: 2 likes
Set your Tesla coil to broil
| | | Re: NPA sizes? WTF? < Reply # 11 on 8/14/2010 5:19 AM > | Reply with Quote
| | | Wow, this is an old thread Like Therrin stated, the nasopharyngeal airway isn't a replacement for the oropharyngeal airway, or visa versa. They each have their own very specific uses. Its a common misconception that an NPA protects the airway the same way and to the same extent as an OPA. This is NOT true. An NPA merely assists in ventilating - that is, giving you a patent path from the nasal cavity onward and up to the oropharynx, provided that the patient is alert and/or securing their own airway. An NPA does NOT prevent the patient's tongue from occluding the airway by dropping back against the posterior oropharynx, which the OPA, on the other hand, is designed to protect against. This is why you use an NPA in a conscious patient or one with a gag reflex, and an OPA for any unconscious/no gag reflex. No gag reflex = no muscle tone = tongue against posterior oropharynx. The OPA should always be the first choice if advanced management is unavailable and the patient meets criteria (negative gag reflex). The presence of a gag reflex can be checked pretty easily by doing a "lash test". Brush your fingertip lightly across the eyelashes of your unconscious patient. If this causes a twitch, this is indicative that they DO have a gag reflex. Remember - NO gag reflex = OPA, YES, = NPA Do not use an NPA on any patient with mastoid ecchymosis and/or other ominous signs of basal skull fracture or any condition that could potentially allow passage of the airway into the cranial cavity. I have never heard of the "pinky" sizing method that was mentioned. NPAs are classified according to a specific sizing index called the French scale. This is a reference to the outer diameter of the airway. Some manufacturers also specify a size in millimeters along with the standard French size. In Canada, we commonly utilize the millimeter measurement, as opposed to the French sizes. Typical sizes are 6.0, 6.5, 7.0, 7.5, and 8.0 NPAs are typically sized by placing the tip of the airway at the outer edge of the nostril and extending it outward to the lower tip of the earlobe on the same side of the head. This method ensures a perfect fit nearly every time. Rarely, you may end up having to go one size smaller than the initial measurement if you find the airway is slightly too large in diameter, usually to account for slightly abnormal nasal architecture.
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