Event Medical Social Media Scan – January 2020 Edition

Event Medical Articles of Interest – December 2019

Resource/Guidance documents (Australia)

Australian Disaster Resilience Knowledge Hub

Safe and Healthy Crowded Places Handbook https://knowledge.aidr.org.au/media/5914/crowded-places-handbook.pdf
Guidelines for music festival event organisers: music festival harm reduction https://www.health.nsw.gov.au/aod/Publications/music-festival-guidelines.PDF

Articles of Interest – Regulation

Major shakeup in regulation of health professionals proposed in B.C. https://www.cbc.ca/news/canada/british-columbia/bc-health-regulation-announcement-1.5375422

Articles of Interest – Research

Impact of mass gathering events on emergency healthcare services: informing health service planning for safer communities
DJ Mag partners with the Global Drug Survey
“Smashing Into Crowds” — An Analysis of Vehicle Ramming Attacks
From Jordan: “The article certainly makes the case for “vehicle interdiction measures” for the public, especially mass gatherings.”

Articles of Interest –  Harm Reduction

[Australia] Victorian ambulance union calls for ‘back-of-house’ pill testing at music festivals this summer
[Australia] It’s a victory for common sense’: NSW music festival bill passes

Articles of Interest –  Others

Surrey hospital to start emergency physician residency program

Med Direction FAQ – Airway Management and Scope of Practice

Hi everyone,

The Challenge

We received a couple of interesting questions last month, submitted by Nathan Innes (Ontario). He has been having some conversations with colleagues and trying to figure out answers to the following:

  1. Is the insertion of a nasopharyngeal airway (NPA)
    within the scope of practice for a paramedic (PCP, ACP, CCP)?
  2. Is the insertion of a NPA in scope for other types of
    health care providers?

History of NPAs

Believe it or not, the
first NPA was invented in the 1870s and it took another few decades for the
oral airway to be invented. NPAs are also known as “nasal trumpets” or “nose
hoses.” They are a good option for airway management if you have a patient who
is too intoxicated to maintain a consistent airway without assistance, but
awake enough that the gag reflex is still intact (and so not a candidate for an
oral airway).

Nerdy, interesting paper about NPAs (a classic): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1726817/pdf/v022p00394.pdf

So, in this case, answering Nathan’s questions directly…

General Approach to Any Scope of Practice

Whenever you are going
to intervene/treat a patient, ask yourself the following questions (the 3 S
Approach – Scope, Support, Skill):

  1. Is this within my SCOPE
    of practice as a professional?
  2. Is this intervention/treatment SUPPORTED by a clinical protocol?
  3. Do I, personally, have the training, knowledge and SKILL to perform a particular

    1. Do I understand the indications, risks, alternatives
      and contraindications for a given intervention/treatment?
    1. Do I have the ability to manage complications that may

SCOPE:  Yes, inserting a NPA is within scope for emergency medical responders
(EMRs), paramedics (PCP, ACP, CCP) and nurses (LPNs, RPNs, RNs) in Ontario,
Alberta and British Columbia.

SUPPORTED:  Yes, this intervention is supported by Odyssey Medical for providers who have this in their SCOPE, and who have received the training and are comfortable with the SKILL. We don’t have a specific written protocol for the insertion “How To’s” of NPAs because it is not our goal to reproduce textbooks specific to each credential and level of training. The insertion of NPAs is part of BLS management of an unstable airway. Some quick resources if you wish to review:

Nathan, thanks for
your questions!

Sheila Turris

Bonus Question:

Why is one end of a
NPA flared?