Scope Expanded to Combitube

[Handsome Robb]

ETT is definitely not a BLS skill.

 

[Shishkabob]

Yeah, it's actually part of the NREMT-B curriculum, I believe.

Trust me, ETT is not an official skill / teaching point for ANY EMT-Basic program.

Your school may teach you so you know a bit more with what Paramedics do, but that's it.

 

[bigbaldguy]

I was shown how to use a king tube at the outfit I volunteer with but I can't imagine a situation I would be called on to use it as all our trucks have a medic. The airline I work for has king tubes in the EMKs we have onboard for inflight Medicals so I guess there is a million to one chance it might come up on an aircraft but I just don't see it being very likely that I would ever do it while on the truck.

 

[tao]

Non-visualized airways are okay for Basics, but something as complex as ETT should be left to medics.

However, if I recall correctly, ETT is technically part of the NREMT-B curriculum. Heaven only knows why.

 

[STXmedic]

Care to elaborate? I'd rather a half-@ssed provider place a supraglotic device than muck up an intubation.

In the last two months, one first responder attempted placing a King in a semi-conscious pt with an intact gag reflex 2/2 low O2 Sats; a second first responder on a separate call managed to attempt a size 5 King in a 5'2"ish patient and couldn't figure out why it was difficult to bag. "They have sizes?" As Ron White so elegantly put it, "You can't fix stupid."

As far as the King tube itself goes, the King LTS-D's wonderful feature of being able to suction the stomach to relieve pressure and limit emesis is great... assuming that you have a means to suction it. A portable hand-suction device is somewhat lacking in this area. What happens when you take fluid under mild pressure, then funnel it into a smaller opening from whence it came? All my firefighters should know this one! Hint: try placing your finger over a water hose... :glare:

By no means am I advocating that "half-@ssed providers" of any level attempt an ETT. I'd much rather show up on scene to find a patient with an OPA/NPA and being bagged, than some mediocre attempt at an advanced airway with a nice wavy or flat line on the EtCO2.

 

[Shishkabob]

As far as the King tube itself goes, the King LTS-D's wonderful feature of being able to suction the stomach to relieve pressure and limit emesis is great... assuming that you have a means to suction it. A portable hand-suction device is somewhat lacking in this area.

We have NG/OG tubes

 

[STXmedic]

We have NG/OG tubes

One of my services does, the other does not. Needless to say, it can be quite frustrating at times when working at the (much) more limited of the two.

 

[Shishkabob]

If an agency has Paramedics, they should also have OG tubes... no reason not to.

 

[STXmedic]

Preaching to the choir, brother.

 

[AMF]

https://www.nremt.org/nremt/about/exam_coord_man.asp#BSkillSheets

Not saying it makes sense.

 

[fast65]

https://www.nremt.org/nremt/about/exam_coord_man.asp#BSkillSheets

Not saying it makes sense.

Damn straight, that makes absolutely no sense

 

[Shishkabob]

It's the NR... since when did they EVER make sense?


Trust me, ETT is not now, nor has it been recently, nor will it ever be, an EMT-Basic skill at the national level.

 

[fast65]

It's the NR... since when did they EVER make sense?


Trust me, ETT is not now, nor has it been recently, nor will it ever be, an EMT-Basic skill at the national level.

hmmmm, how do I know I can trust you? h34r:

 

[CAOX3]

I was trained on multiple advanced airways including ETI, leave the intubations to the medics, I can manage the majority of airways with a bvm an a adjunct.

 

[AtlantaEMT]

Has anyone ever had a medic use a combitube? I had a medic once who used it on a full code. I went for the intubatin kit but he told me to get the combitube.

 

[usalsfyre]

Has anyone ever had a medic use a combitube? I had a medic once who used it on a full code. I went for the intubatin kit but he told me to get the combitube.

I use them (King LTS-D anyway)first line in all of my cardiac arrest, and used one first line on a patient who needed airway control but was not a good candidate for endotracheal intubation the other day.

 

[Handsome Robb]

The local service just changed their protocols to the KING as well as a first shot airway in arrests. Only problem I have heard about with the KING is if the pt vomits they have a tendency to dislodge, so you have to drop an OG tube through the port on the KING and suck it all out before it can happen.

 

[calebsheltonmed23]

To the Paramedics who browse the BLS forum,
EMTs in my area (Dallas) recently became able to use combitubes and ET Intubation (and maybe King's?). Do you recommend learning these (I'm a student) or will paramedics mostly take care of this? Also, do people in your profession have some sort of problem with EMTs performing advanced airway interventions? Do you think it's something requires the basic-science background/high clinical exposure you must have?

I would recommend learning it. I've been told numerous times to drop a combitube during a code, while the medic was getting an IV/IO established. And as an EMT-P student, I'd rather have an EMT drop a tube while I'm pushing drugs because that's precious time being wasted if you have an EMT just sitting around and your not pushing drugs, in my opinion.

 

[jjesusfreak01]

I would recommend learning it. I've been told numerous times to drop a combitube during a code, while the medic was getting an IV/IO established. And as an EMT-P student, I'd rather have an EMT drop a tube while I'm pushing drugs because that's precious time being wasted if you have an EMT just sitting around and your not pushing drugs, in my opinion.

This is exactly why we use King airways. With a King airway available to them, an EMT has the complete ability to manage an airway during a cardiac arrest, leaving the medic free to start drugs or electrical therapies.

 

[Veneficus]

I would recommend learning it. I've been told numerous times to drop a combitube during a code, while the medic was getting an IV/IO established. And as an EMT-P student, I'd rather have an EMT drop a tube while I'm pushing drugs because that's precious time being wasted if you have an EMT just sitting around and your not pushing drugs, in my opinion.

Did anyone in school tell you just how much those code drugs actually help?