When should a nasopharyngeal airway not be used?
Absolute contraindications for NPA and NT intubation include signs of basilar skull fractures, facial trauma, and disruption of the midface, nasopharynx or roof of the mouth.
Can a conscious casualty tolerate a nasopharyngeal airway?
Nasopharyngeal airways are also used to keep the airway open and can be used with patients who are conscious or semi-conscious.
When do we use NPA?
Unlike the oral airway, NPAs may be used in conscious or semiconscious individuals (individuals with intact cough and gag reflex). The NPA is indicated when insertion of an OPA is technically difficult or dangerous. NPA placement can be facilitated by the use of a lubricant.
Which is a contraindication to the use of an oropharyngeal airway?
If the patient can cough, they still have a gag reflex, and an oral airway is contraindicated. If the patient has a foreign body obstructing the airway, an oropharyngeal airway should not be used. An oropharyngeal airway should not be used on patients who have nasal fractures or an actively bleeding nose.
What are the indications for using a nasopharyngeal airway?
Indications for an NPA include relief of upper airway obstruction in awake, semicomatose, or lightly anesthetized patients; in patients who are not adequately treated with OPAs; in patients undergoing dental procedures or with oropharyngeal trauma; and in patients requiring oropharyngeal or laryngopharyngeal suctioning …
What can happen if the oropharyngeal airway is too large?
An airway that is too large may reach the laryngeal inlet and result in trauma or laryngeal hyperactivity and laryngospasm. It is common practice by some clinicians to insert an oropharyngeal airway device upside down, or convex to the natural curvature of the tongue and then to rotate the airway 180 degrees.
What is the most effective way to deliver bag mask ventilation?
“Bag-mask ventilation is most effective when provided by 2 trained and experienced rescuers. One rescuer opens the airway and seals the mask to the face while the other squeezes the bag. Both rescuers watch for visible chest rise.”
What is a potential complication of using a nasopharyngeal airway that is too long?
Airway Trauma Long-term use of a nasopharyngeal airway may cause ulcers, particularly if you use a tube that is too rigid or too large. Selecting the right tube and ensuring that you can see the airway prior to intubation greatly reduces the risk of serious injuries.
How do you know what size oral airway to get?
Select the proper size airway by measuring from the tip of the patient’s earlobe to the tip of the patient’s nose. The diameter of the airway should be the largest that will fit. To determine this, select the size that approximates the diameter of the patient’s little finger.
What is the most common complication after inserting an oral airway?
Two major complications can occur with the use of OPAs: iatrogenic trauma and airway hyperreactivity. Minor trauma, including pinching of the lips and tongue, is common. Ulceration and necrosis of oropharyngeal structures from pressure and long-term contact (days) have been reported.
When do you use a supraglottic airway?
Supraglottic airways (SGAs) are a group of airway devices that can be inserted into the pharynx to allow ventilation, oxygenation, and administration of anesthetic gases, without the need for endotracheal intubation.
What is the typical size of a nasopharyngeal airway in adults?
Typical sizes include: 6.5 mm/28FR, 7.0 mm/30FR, 7.5 mm/32FR, 8.0 mm/34FR, and 8.5 mm/36FR.
How often should a nasopharyngeal airway be changed?
More frequent occlusions may occur during this time from the trauma of initial insertion. After this period it should be routinely changed every 5-7 days, with alternating nostrils utilised. If the NPT is required over long-term, size and length may need adjusting according to patient’s growth.
When inserting a nasopharyngeal airway what should you do if resistance is felt?
Be gentle when inserting any type of airway device. Use a water soluble lubricant when inserting a nasopharyngeal airway. If resistance is felt during insertion of a nasopharyngeal airway, stop and try the other nostril.
When should an oral airway be considered?
Use an oropharyngeal airway only if the patient is unconscious or minimally responsive because it may stimulate gagging, which poses a risk of aspiration. Nasopharyngeal airways are preferred for obtunded patients with intact gag reflexes.
When do you use oral or nasal airway?
Advanced Airways In a deeply unresponsive/unconscious patient, an oropharyngeal airway is safe to use because the gag reflex will be depressed. Another advantage of the nasopharyngeal airway is that it can be used in patients with mouth trauma, where an oropharyngeal airway cannot or should not be used.
Which of the following is an example of an advanced airway?
Advanced Airway Examples are supraglottic devices (laryngeal mask airway, laryngeal tube, esophageal-tracheal) and endotracheal tube.
What are considered advanced airways?
Endotracheal Tube The endotracheal (ET) tube is an advanced airway alternative. It is a specific type of tracheal tube that is inserted through the mouth or nose. It is the most technically difficult airway to place; however, it is the most secure airway available.
How do you know if someone is protecting their airway?
It is endangered by blood, secretions, vomitus, inflamed tissue, or a foreign body. If you insert a tube from the outside to the inside to open up the upper airways and the patient doesn’t need supplemental oxygen or increased ventilation, then that is airway protection.
What is the compression to breath ratio when using an advanced airway?
Airway Management
| Compression to Breath Ratio | No Advanced Airway | Advanced Airway |
|---|---|---|
| Adult | 30 compressions followed by two breaths | One breath every 6 to 8 seconds without pauses in compressions |
| Child/Infant | 15 compressions followed by two breaths | One breath every 2-3 seconds (20-30 breaths per minute) |