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DannusMaximus wrote:I would think a nasal would be less effective than an oral, simply because the size of the tube is smaller. Physiologically this might not be an issue, just a thought. We use nasal, oral, and combitubes on our department. I usually base which I use on the level of consciousness of the patient and the anticipated arrival time of the transport ambulance. If I can see or hear the ambulance coming shortly after we arrive on scene, I'll usually hold off on the combitube, because a dedicated endotracheal tube is kind of the gold standard for airways, and a standard oral will do fine for the few minutes it takes for the paramedic to prep to intubate the patient. If we're going to be minus an ambulance for much longer than that (pretty common) I'll generally use a combitube.
dogbane wrote:It's not your post count, it's making posts count.
ehunter72 wrote:Also I think it is much harder to guesstimate the propper size of an Opa than it is to guess at a Opa, it either fits in the hole or it dont, just a thought.
gimpface wrote:I'm not really sure. I've seen firefighters who have placed dozens of NPAs balk at putting in OPAs... I just asked my partner his opinion, he thinks they're afraid of being bitten. In a zombie apocalypse, this seems perfectly reasonable.
gimpface wrote:I assume that by "J-tube" you're referring to OPAs. With an unresponsive person, I like to drop an OPA first, because this tells me if the patient has a gag reflex. If not, they need to be intubated. If they are unresponsive but do have a gag reflex .
ehunter72 wrote:Keep in mind that NPa's and OPa's are at the firstresponder/ EMT-b level (while some states allow B's to combi tube.
I think that is why EMT-P's and above use them far far less.
DannusMaximus wrote:I would think a nasal would be less effective than an oral, simply because the size of the tube is smaller. Physiologically this might not be an issue, just a thought.
Paras used to pretty routinely remove the combitubes we dropped, so fire kind of got away from using them - - they're sort of expensive to use for 2 minutes than throw on the floor. Recently, though, it seems like the transport service is leaving the combitube in place if we've got one in, so I'm using them more.
Both nasal airways and oral airways (and combitubes, really) are quick and easy to use with a little practice. Proper size selection and lubrication is the key for nasals, size is key for the orals.
PotatoMuncher wrote:Used one when a Pesh Merga soldier took a bullet to his upper jaw. Dude had all sorts of bits in there: Teeth, flesh, blood, tongue, etc. He started to choke on some of it, and when I saw air bubbles emerging from the back of his mouth, I decided to drop a pretty long NPA down there. It worked as a make-shift intubation until I could get my King LT out. Might not be a super amount of air getting down there, but it's better than nothing.
Other than that, I kept it for the exact reasons that gimpface stated. That and for new E1's and E2's to try out when they got bored.
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