OPA, NPA & BVM

Question 1

Indications for an OPA

Answer 1

Should be routinely placed in all patients requiring airway support unless there is a good reason not to

Question 2

Contraindications of an OPA

Answer 2

Patients who are conscious or semi conscious with an intact gag reflex

Question 3

Potential complications of an OPA

Answer 3

1. Gagging, vomiting, aspiration
2. Trauma to mouth structures
3. Dental injury from biting
4. Inadequate airway protection without adequate positioning

Question 4

Preparation and insertion of an OPA

Answer 4

1. Correctly measure from corner of mouth to earlobe
2. Ensure patient is supine
3. Insert concave upwards until the tip reaches the back of the tongue then rotate 180 degrees
4. Flange positioned on top of teeth & under lips
5. Able to troubleshoot by inserting concave down in adult
6. Able to state difference in small children & infants, inserting concave down (to avoid trauma to ouch structured as infants do not have a hard palate to protect mouth from potential trauma of an OPA)

Question 5

Indications of an NPA

Answer 5

Patient requires airway support but has trismis, damage to oral cavity or gag reflex & OPA can’t be placed

Question 6

Contraindications of an NPA

Answer 6

Nasal trauma or extensive maxilla facial trauma

Question 7

Potential complications of an NPA

Answer 7

Epistaxis, ulceration, sinusitis, gag reflex

Question 8

Prep and insertion of an NPA

Answer 8

1. Measure from corner of nose to earlobe
2. Ensure patient is supine and locate largest nostril
3. Lube NPA
4. Insert aiming straight back
5. Troubleshoot by rotating or changing nostrils

Question 9

Indications of a BVM

Answer 9

1. Administration of high flow O2
2. Providing PEEP (non HA)
3. Assisting ventilations or controlled ventilation

Question 10

Contraindications of a BVM

Answer 10

None

Question 11

Cautions of a BVM

Answer 11

Active vomiting or insufficient breathing to open duckbill valve

Question 12

Potential complications of a BVM

Answer 12

Hyper/hypoventilation
Over ventilation leading to gastric inflation & increase intrathoracic pressure
Barotrauma
Asphyxiation due to duckbill valve not opening adequately

Question 13

Prep & insertion of a BVM

Answer 13

1. Have appropriate OPA/NPA inserted
2. Assemble BVM with all parts : correct sized mask, filter, PEEP, BVM chamber, reservoir bag, O2 tubing, O2 (10 LPM)
3. Demonstrate CE grip with head tilt chin lift
4. Demonstrate double handed VE grip and the head tilt chin lift
5. Demonstrate delivering ventilations using the Rule of 3’s : 1/3 of the bag, 3 fingers, no more than 3 seconds