Sunday, August 28, 2011

NPA used for suction

   During our WEFR course we introduce the skill of suctioning a compromised airway of a casualty. For the Wilderness First Aid level of training the best was to clear an airway is to roll the casualty over and let gravity do the dirty work.
   That is still the best option for the medical professional. The difference is that it is important to have a few more skills in your tool box to deal with situations where rolling a casualty might not be the best option.

   Suction is a city based skill that is taught at the Emergency First Responder level. In the remote or wilderness context, this skill is vitally important. Managing a casualty's airway is difficult even when all the toys are available. When out in remote areas you only have what you carry.
   Improvisation is the ultimate key.

   Having kit that does more than one thing is highly regarded in Wilderness Medicine. Let's take a look at a couple of toys that you would normally carry that can be used for an excellent suctioning option:
   60ml syringe:
       This little buddy can be used for foley placement, irrigation of wounds especially puncture wounds, inflating ET tubes, clearing out ear wax and a number of other options.
   Nasopharyngeal Airway:
       This is mainly used for keeping the tongue off of the back of the throat and allowing an semi conscious casualty to breath. It is an extremely safe and non invasive tool for your airway management.

   Now, put those two together and you have a suction device that can reach further back into the mouth to suction out anything causing airway issues.

   As with all suction devices make certain that you put the end of the NPA as deep as you can see. It is a lot softer than any of the other purpose made suctioning devices and therefore is much safer. But still, do not place any suctioning device anywhere where you cannot see the tip. 

   The best part of our jobs as remote medics is all of the toys that we get to play with. But anytime that I can create an option where I can lighten my medical ruck by implementing an improvised device I am apt to adopt it. 

more information can be found at Remote Medicine Ireland

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