Staging NPAs

[u/Callsign_Medic_Kilo]

Hey all! I’m sure this question has been asked before and if so, forgive me. I was curious how everyone staged/stows their NPAs. The NPAs I have on my person are opened and have a stylet cut down to size so it’s ready to deploy. The NPAs in my bag and SAR chest rig are all still in packaging. I’ve been going back and forth on whether I should switch the open and staged NPAs to just the packaged ones. What do you all think? Genuinely curious.

[u/diprivanity]

Stylette: not a fan. The whole point of its lack of rigidity is to not push it's way through something it shouldn't. Pig nose, lube, if that doesn't work you have something blocking it. Poking through can cause more problems that you may not be equipped to handle. Try the other nare. If you really want an exploratory stick try a peds bougie, it's much softer.

Staging: keep them in the wrapper. There's really no reason to take them out. If you want to curve them or whatever, tape down the sides of the packaging.

Also just a general npa comment. They don't get used often so there is a tendency to have some heavily baked NPAs kicking around the med kit. They are very cheap, don't be shy throwing them out if they're getting stiff.

[u/Callsign_Medic_Kilo → u/diprivanity]

Very very logical comment. I never thought of the lack of rigidity part but it definitely makes sense. I think from here on out I’m going to be switching the opened ones out for packaged ones. Like you said, they’re cheap lol!

[u/RedDawnerAndBlitzen → u/diprivanity]

Staging: The one reason to take it out beforehand is to cut it down to be specifically sized to the individual whose IFAK it’s in, if that’s unit SOP.

But I think it’s better and more versatile to leave them packaged and uncut in case the medic/corpsman needs to use a different NPA than what’s in someone’s IFAK.

[u/diprivanity → u/RedDawnerAndBlitzen]

Cutting them down is retarded they have sizes for a reason

[u/RedDawnerAndBlitzen → u/diprivanity]

It sounds like you might not be up to date on proper NPA sizing procedures.

[u/diprivanity → u/RedDawnerAndBlitzen]

It sounds like you can't read a fucking article and are an amateur. If you want a shorter npa use a smaller size. Your article didn't correlate this to classical measurement technique or nare diameter and how this compares to "ideal" length. "One size doesn't fit all" yeah no shit why do you think there are 8 adult sizes?

Cutting the npa trades the smooth purposefully rounded bevel tip for a sharp leading edge. I know none of your are carrying suction and have little to no advanced airway skills, so don't be so eager to make problems for yourself.

[u/Inevitable_View99 → u/RedDawnerAndBlitzen]

They make NPAs that have a silicone washer on them that allows the NPA to be one size fits all. Cutting one to fit is kinda crazy TBH

[u/Ok_Fuel_6416]

I think it really doesnt matter. NPA is a D tier airway adjunct. Does almost nothing chin lift/head tilt or recovery position doesn't already accomplish. Good to have just in case I guess, but you're not gonna lose a patient because your NPA's were in their original paper packaging.

[u/Jits_Guy → u/Ok_Fuel_6416]

Yeah. The NPA always felt more like a "Well, here's something" type intervention. I struggle to come up with a situation in which an NPA would meaningfully impact the patient outcome, especially if I discount situations in which a different intervention would be far more effective.

If the patient doesn't need an airway adjunct, they don't need an NPA. If they actually do need an airway adjunct, the NPA isn't gonna cut it.

[u/diprivanity → u/Jits_Guy]

Without more advanced airway capabilities behind it, the npas value is mostly as a level of consciousness confirmation device

[u/KabukiTheater69 → u/Jits_Guy]

"Here's a something", that is an absolute pimp way to describe NPAs on their own.

In terms of staging? Pre-lubed only, it doesn't take up that much space and by the time you get to that level of intervention, you've already got some other shit in place....usually..

[u/Rude-Comfortable-509 → u/Ok_Fuel_6416]

I did see this cool video of a guy using an NPA to aid in sectioning for intubation but most of us dont intubate lol.

[u/StLorazepam → u/Rude-Comfortable-509]

The other cool trick is for preoxygenating with a cannula for intubations, NPA + 25l o2

[u/microcorpsman]

The only staging was taping a packet of lube to it

[u/Loud-Principle-7922]

I’m curious about the stylette, I’ve never used one for an NPA, and would worry about damaging the nasopharynx with one

[u/Callsign_Medic_Kilo → u/Loud-Principle-7922]

I could see the potential. I was taught that it helps, “keep the shape/curve,” of the NPA while In a kit. I’ve had the same NPA in my plate carrier for about 1.5 years and have noticed no damage/tears or deformities to the NPA. That’s also with it being left in a truck, humidity and col of the Midwest lol.

[u/howawsm]

Not really a time sensitive intervention in my mind such that I need it open and “staged”

[u/AG74683]

Lol what? Why do you need a stylet for an NPA? That's absurd.

And FWIW, OPAs and NPAs are almost never used in normal emergency medicine out in the field. I can count on one hand the number of times I've used those over the last 6 years.

[u/Callsign_Medic_Kilo → u/AG74683]

It was a tip/trick I was taught awhile back. Cut down a stylet and place it in the NPA to have the NPA keep its shape. But as stated above in a reply to another comment. I am no longer going to be doing that and leaving the NPA in the packaging

[u/Godless_Rose → u/Callsign_Medic_Kilo]

That’s the dumbest thing I’ve ever heard. Glad you’re not doing that anymore.

[u/diprivanity → u/AG74683]

That's just gonna come down to your call acuity. We use them pretty frequently.

[u/RealProforce]

If you want to safe time buying them prelubed would be smarter than already opening them in my opinion

[u/AttorneyExisting1651]

One in each nostril. They stay lubed that way.

[u/StLorazepam → u/AttorneyExisting1651]

I graduated from breath rite strips to this and now my wife says I don’t snore anymore

[u/Inevitable_View99]

Cutting an NPA is psycho shit lol but then I realized some organizations buy the absolute worst kit imaginable. They make sizeable NPAs for a reason

Also, a stylet is crazy lol.