The Why Didn’t I Think Of That NPA?

Mercury Medical has a truly innovative nasopharyngeal airway, that they don’t even really market that much to EMS. But it is very cool. I’ve rarely used NPA’s. They are just an awkward fit in EMS.

If a patient is breathing, most of us lean towards a non-rebreather mask. If they aren’t we lean towards an ETT or SGA and a BVM. But this product has changed my mind about both when and how we treat a significant subset of patients we serve regularly.

The typical narcotic overdose is somebody still breathing, but maybe not breathing that great. Respirations 6-8, obviously diminished and dropping respiratory drive. Dropped O2 Sats, Increasing CO2. So what do you do?

Most folks immediately start bagging to assist respirations. Then they bang a big load of Narcan. What happens is the patient wakes up in a few seconds going through withdrawals. EMS looks like a street hero. The patient suffers unbelievable pain.

What if we did this a little differently? The Naso-Flo Nasopharyngeal Airway Device is a soft and gently placed NPA which has an oxygen port. It both helps improve airway control and passively delivers oxygen at the same time.

The real beauty of an NPA is the patient can easily and safely self-remove it. No balloon, they just yank and it’s over. No harm, no foul. Now imagine an airway which is that inherently safe, that can also improve O2 Sats. Clever don’t you think?

The way I would use it is to lubricate the Naso-Flo, slide it in and then hook it up to O2. Then I’d start a line and very slowly start giving small slow carefully titrated doses of Narcan. Just enough to get them breathing decently. Not enough to wake them up or send them into the screaming heebie jeebies.

I don’t have to become an aging WWF wrestler, the patient does not unduly suffer, and we get to take him somewhere where there are professionals that can be his detox support. When you leave a guy on the street after an OD, anything can happen. Maybe they die later today and then you look kinda bad. It has happened.

I love the Naso-Flo because it’s a kindler gentler way. We do what the patient needs, airway and O2 support. We don’t do a bunch of stuff they don’t really need. A good idea don’t you think?

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About Dan White

I'm a retired Paramedic and EMS Instructor with 35 years EMS and emergency medical product experience. I love canoes, cars and EMS. I have written a lot about EMS Technology on the Paramedic Blog, the Insights on Innovation column for, on and I can be reached directly at 573-240-0002.
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