Some texts state that NPAs are contraindicated in head injured patients, esp
if suspecting a basal skull fracture. A Medline & Embase search has yielded
only one case of documented intra-cranial penetration by an NPA. This was in
a patient with an depressed fronto-parietal open fracture, Le Forte 3
fractures & multiple other injuries. My feeling is that patients are far
more likely yo benefit from a patent airway than to suffer neurological
injury.
There are multiple reports of NG tubes & occasional reports of NT tubes
entering the brain through basal skull fractures. There is even a report of
an NG tube entering the brain in the absence of any trauma; thats what I
call brute force!
Is there any sound reason why ambulance crews shouldn't use NP airways?
John Apps
BASICS North East
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