Airway and the Naso-Pharyngeal Airway

Continuing the series in MARCH, we have just finished Massive Hemorrhage and now progress to Airway.

Our concern in Airway is making sure the casualty can get air from the environment into their lungs. We do that by making sure the pathway is open. Or, in medical speak, we want to make sure the airway is patent.

There are a few ways to do this, most are familiar with the head-tilt-chin-lift. It is mostly used in CPR and in civilian trauma care. You are simply lifting up on the head by tilting the chin upward to prevent the tongue from blocking the airway. The only problems with this are in order for it to keep working, someone has to do nothing else but hold head-tilt-chin-lift. It’s hard to keep an airway open with this method while moving. So instead of doing any sort of manual airway method, we use airway devices. Specifically an NPA or Naso-Pharyngeal Airway.

An NPA is a piece of soft plastic or rubber that is used to keep an airway open. It is inserted into the nose (generally the right nostril) and pushed down until the flange is flush with the nose. It can be inserted in anyone that is conscious or unconscious. The only people that can not get an NPA are those with any sort of maxillofacial trauma. You can identify this through any bruising around the eyes (raccoon eyes) or bruising at the base of the skull (battle signs).

Make sure you use lubrication when inserting an NPA, most should come with some sort of lube packet. The ones in the Stuck Pig Medical IFAK do. If you don’t have lube you can use (in order) water, their spit, or your spit. No blood, it can clot and plug the NPA which defeats the purpose of applying one.

If you are interested in learning how to secure an airway, come on out to class. We have room in the class this weekend and would love to have you.

Does your medical kit contain NPA’s?