MCGLYNN_EMTP
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I keep reading articles on intubations in the field and how studies are really leaning towards simply using sup. O2 and BVM verses actually intubation the patient. What do you guys think about this???
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I keep reading articles on intubations in the field and how studies are really leaning towards simply using sup. O2 and BVM verses actually intubation the patient. What do you guys think about this???
I keep reading articles on intubations in the field and how studies are really leaning towards simply using sup. O2 and BVM verses actually intubation the patient. What do you guys think about this???
I am deeply, deeply suspicious of anything authored by Henry Wang as it is very clear that he has an agenda, for whatever reason that seems to be about denying medics the ability to control airways.
One of the oft cited 'studies' into the alleged deleterious effect of prehospital intubation is Wang's Out-of-hospital endotracheal intubation and outcome after traumatic brain injury, Ann Emerg Med 2004.
I challenge anyone to read this study with anything other than tears, either from laughter, because it is clearly a joke, or from sadness that this tripe is held up as a shining beacon of prehospital research.
Prehospital ETI certainly needs more research into it, however I see the downside of ETI not being whether it is good or bad, but whether medics do it well or poorly. If we continue to hand out laryngoscopes to people who are only hitting the mark 80% (or less) of the time, then of course we are going to have undesireable outcomes.
All that the research currently shows is that airway management done badly is of no use.
However if we actually give a damn, educate and train medics appropriately, allow them to gain experience and give them the tools (such as RSI) to properly control an airway, then we can start carrying out some decent prospective, randomized trials and get some answers.
I'm going to come off as terribly arrogant for this, and I really do apologize, but we're learning ETT and dual lumens as a supplemental skill in our EMT-B class.
...I think we are better off placing blind airways, and letting the hospital handle more appropriate airway management
Prehospital ETI certainly needs more research into it, however I see the downside of ETI not being whether it is good or bad, but whether medics do it well or poorly. If we continue to hand out laryngoscopes to people who are only hitting the mark 80% (or less) of the time, then of course we are going to have undesireable outcomes.
All that the research currently shows is that airway management done badly is of no use.
However if we actually give a damn, educate and train medics appropriately, allow them to gain experience and give them the tools (such as RSI) to properly control an airway, then we can start carrying out some decent prospective, randomized trials and get some answers.
'Nuff said really. But just so everyone get's the point clearly, here goes.Personally I don't see the issue as a lack of training/poor training but (for many) a lack to use the skill. I don't think anyone would argue there is a huge difference between tubing dummies in a class room, versus getting ETT in the OR and then translating that to some of the situations we deal with in the field, then doing enough field intubations to remain completely proficient. Most of the research (not just Wang as I agree with you about him) shows that as a whole we don't hit tubes as often as we think and more frightening we don't recognize the fact we have misplaced a tube.
I'm going to come off as terribly arrogant for this, and I really do apologize, but we're learning ETT and dual lumens as a supplemental skill in our EMT-B class.
Dallas FD and a few other FD's send their new recruits to the medic school based out of UT SouthWest medical center... and rumor has it that they are going to drop intubation from the curriculum.
I'm going to come off as terribly arrogant for this, and I really do apologize, but we're learning ETT and dual lumens as a supplemental skill in our EMT-B class.