# Airways for EMTs



## NBFFD2433 (Nov 12, 2013)

In your guys states do the allow advanced airways such as King LT and Combitude. They don't in NC.


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## TransportJockey (Nov 12, 2013)

Supraglottic airways as a whole are allowed for BLS providers in the state of NM.


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## nwhitney (Nov 12, 2013)

TransportJockey said:


> Supraglottic airways as a whole are allowed for BLS providers in the state of NM.



King and Combi are allowed in Oregon


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## TRSpeed (Nov 12, 2013)

King and combi in Kern County CA


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## NBFFD2433 (Nov 12, 2013)

I wish we could. :sad:


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## DesertMedic66 (Nov 12, 2013)

Just NPA and OPA for the majority of CA.


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## NBFFD2433 (Nov 12, 2013)

DesertEMT66 said:


> Just NPA and OPA for the majority of CA.



Same in NC.


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## Mariemt (Nov 12, 2013)

King here, combi  for most EMTs also if in protocol.


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## CodeBru1984 (Nov 13, 2013)

DesertEMT66 said:


> Just NPA and OPA for the majority of CA.



NPA and OPA here in SD County, unless you are part of the Petco Park team and then, under their medical director, you are able to use king airways.


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## 9D4 (Nov 13, 2013)

Arizona allows for King's. I'm sure Combitubes also, but no one at all uses them.


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## Christopher (Nov 13, 2013)

NBFFD2433 said:


> In your guys states do the allow advanced airways such as King LT and Combitude. They don't in NC.



Yes they do. I don't know where you work in NC, but they certainly do.


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## DAN911 (Nov 13, 2013)

Combitube here in the Province of Québec.


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## unleashedfury (Nov 13, 2013)

PA its NPA or OPA only. 

Rescue Airways can be used by ALS providers, however usually they are used after intubation attempts are unsuccessful.


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## emt11 (Nov 15, 2013)

NPA, OPA, King, Combi, LMA in GA. Basically any BIAD.


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## Christopher (Nov 15, 2013)

NBFFD2433 said:


> In your guys states do the allow advanced airways such as King LT and Combitude. They don't in NC.



Just to clear up any confusion about North Carolina and airways:

EMR's and higher may place OPA's and NPA's.

EMT's and higher may place KingLT's and Combitubes (or any equivalent BIAD approved by their medical director). The only restriction is the patient must basically be in cardiac arrest.

(we place King's as EMT's on my industrial fire brigade...)


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## EMT B (Nov 15, 2013)

Maine: NPA/OPA

WV: NPA/OPA/King/Combi


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## MedicOfReddit (Nov 15, 2013)

In Chicago, Illinois EMT-B's can place king LT airways on cardiac arrest patients specifically.

Last I heard was that the Combitube was being replaced fully by King LT airway. (source was one of my instructors for my EMT class)


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## MaroonMedic (Dec 12, 2013)

In my area, basics are trained and allowed to insert combitubes.


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## EMT856 (Dec 13, 2013)

Its sort of stupid not to give EMTs King airways or LMAs. They are (almost) idiot proof.


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## NomadicMedic (Dec 13, 2013)

EMT856 said:


> Its sort of stupid not to give EMTs King airways or LMAs. They are (almost) idiot proof.



Almost. EMTs should concentrate more on becoming proficient with a BVM before worrying about what new skills and toys they think they deserve.


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## Tigger (Dec 13, 2013)

DEmedic said:


> Almost. EMTs should concentrate more on becoming proficient with a BVM before worrying about what new skills and toys they think they deserve.



Although by the same token, using an SGA can significantly cut down on complications associated with just using a BVM. My thought is that if a patient can tolerate an OPA and an SGA is available, it should be placed. It does a much better job preventing gastric distension and may also prevent aspiration.

Of course not every patient requiring manual ventilation can tolerate an SGA, so you are of course right, EMTs do need to be much more proficient with the BVM.  

I am just of the belief that if we have the tools available to help negate potential consequences of a fairly low-use skill, we should use them.


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## jpregulman (Dec 13, 2013)

OH allows king/lma and the like for pulse-less and apnic pts.


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## Carlos Danger (Dec 13, 2013)

Tigger said:


> Although by the same token, using an SGA can significantly cut down on complications associated with just using a BVM. My thought is that if a patient can tolerate an OPA and an SGA is available, it should be placed. It does a much better job preventing gastric distension and may also prevent aspiration.
> 
> Of course not every patient requiring manual ventilation can tolerate an SGA, so you are of course right, EMTs do need to be much more proficient with the BVM.
> 
> I am just of the belief that if we have the tools available to help negate potential consequences of a fairly low-use skill, we should use them.



Exactly. 

There is plenty of research out there showing that EMT-B's can effectively use SGA's. I can think of no reason why they shouldn't be a BLS skill.


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