King vs. Intubation

[d_miracle36]

What your arguing is that poor ETI is worse than good King placement, without really addressing good ETI, or bad work with a King.

Further, recent research (ROC PRIMED) suggest that the patient DOES care how ventilations are delivered (the author I spoke with mentioned 50% worse outcomes with a King vs ETI) but we're not entirely sure why.

Yes poor ETI is worse than good king placement. Good ETI is of course better than than bad king placement and vice versa.

In my opinion appropriate bvm ventilations would make a patient happy. Good ETI would make a patient happy and good King placement would make a patient happy.

Apparently in pigs SGA's impair carotid blood flow
http://www.ncbi.nlm.nih.gov/pubmed/22465807?dopt=AbstractPlus

And in some studies no ventilations at all lead to better outcomes
http://circ.ahajournals.org/content/116/22/2514.full

I dont think this alone will make me change my practice but may be something to look forward to in the future.

 

[Shishkabob]

There's tons of evidence that ETI is detremental to patient outcomes after cardiac arrest. I just finished a paper on the studies for paramedic school.

And there's newer studies coming out saying just the opposite, that ETI is actually beneficial, and in some cases, Kings are bad.


Such is medicine, it will always go back and forth.

 

[d_miracle36]

The question isn't whether EtCo2 works with both ETI and Kings, the question is if they are the same. Yes, there have been studies done that show basic airway maintenance is better that either ETI or a King. Not to repeat myself, but just because ETI can be detrimental to outcomes doesn't mean the king can't be more detrimental.

Yes I agree with you 100% that both can be detrimental and the king may be more detrimental, I dont know. Does anyone?

 

[Christopher]

And there's newer studies coming out saying just the opposite, that ETI is actually beneficial, and in some cases, Kings are bad.

That study also showed, but didn't highlight, that not using a King or ETT (or even never successfully establishing an advanced airway) was better.

Non-rebreather and an OPA for at least the first half the code!

 

[MrJones]

Would it be possible to get links/citations for some of these studies that are being bandied about? I'd like to read up on some of them.

thx.