knxemt1983
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we can use them, but only if no als available, or greater than 5-10 away and the pt is running out of steam very rapidly
Advanced Airways for Basics
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BossyCow
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Do you have any idea how arrogant that post reads? You assumed things about me based on a bias that you have. Now you post that I have achieved your grudging acceptance and my dissatisfaction is now worthy of your approval? Wow.. gee.. thanks!
PinkEmtGurl
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I was taught use of the Combitube in EMT Class several years ago in Colorado Springs, the services i've been with since do not allow Basics to use the combitube, however, if you think about it, they are stupid proof! You don't have to use a laryngiscope and you don't have to know what the vocal cords or any of the airway looks like, you just shove the tube down, inflate a bubble and it's there... Not much thought involved!
Onceamedic
Forum Asst. Chief
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well.. it would be nice if you listened for breath sounds to see if its in the treachea or the esophogeus... not good to start bagging the patient's stomach...
PinkEmtGurl
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I do understand the concept of listening for breath sounds but it really isn't that difficult to shove a tube down someones throat! Either way it's in the right place one way or another. The point that I was getting at here is that it's not that difficult of a skill...and there's no reason why Basics shouldn't be able to do it.
I am going to try to type this without it sounding condescending.
Don't ever take anything that is AIRWAY that lightly!! The vocal cords and larynx are very easily damaged. The esophagus is very easily torn. Any of these complications may make any further rescue attempts nearly impossible. If the patient wasn't dead before, they just might be now.
Thank you so much. You have done what I have been unable to do. You have proved, beyond any reasonable doubt, that emt-b should never be allowed to use an ETC.
PinkEmtGurl
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I'm really sorry that your gold patch went to your head but there really isn't that much thought required in placing a combitube and if Basic's are taught it in school, there's no reason they shouldn't be able to place one if needed when an ET Tube can not be placed or ALS intervention is not available...
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Play nice, boys and girls.
beckoncall62
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Ridryder911
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Do you realize that you and your ideas, are a prime example of why most states do NOT allow Basics to use advanced airway.
First it is a laryngoscope.. if you are to claim it, at least spell it right, second you should NEVER shove anything down a throat and as well it is NOT a bubble it is called a cuff!
Geez, it is quite obvious that you were not even taught the proper names, and now you expect me to trust you on insertion of the device that you don't even the name of the parts of it? So you took a a little more than an advanced first-aid class, and now you believe that you can properly insert and utilize an advanced airway?
Again, it is not the technique or skill!! A monkey could be taught that! It is the knowledge of risks, what to do in case of failure, complications, and yes... being able to control the airway other than that device.
If you do not understand why most basics are not taught and cannot.... then instead of attempting to just stating your opinion, educate yourself on airway techniques, ventilation and oxygenation of patients. Then afterwards, see how much education you really had prior to that statement instead of shooting from the hip.
R/r 911
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emtkelley
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Thanks Pink. This is why basics are constantly bashed in public forums. Ugh....
Who cares about spelling anymore when the schools don't?
There's a new PDQ factory in Florida that has a major typo on their website. Even after 2 weeks of courtesy emails and a phone call, it's still there.
Or, could it be Endotracheal incubation is a new skill?
http://www.floridacareerinstitute.edu/emergency_medical.htm
The PATIENT CARE TECHNICIAN program sounds longer and better structured.
Rattletrap
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You know I always thought that the layyngoscope was the "thingy with the light, and the cuff was the "thingy you blew up on the tube".
:huh::blush:
Jay114
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Obviously all Basics cannot be judged by the words of one...
although her words did make me wince...
although her words did make me wince...
IrishMedic
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i'm an EMT-B, i trained in ~Indiana and we were trained in combitude, and it was a stage in our practicals for NREMT. i cant comment on whether or not they are allowed use this skill on the local BLS units. but i have also done a course on ADV. Airways, to better my knowledge and skill, i can understand where all the ALS and BLS providers are coming from in this thread....but the point is, although the majority of us strive to improve standard of care for our patients, either by training as ALS providers, or pushing for Better training or getting more training hours to keep up skills we dont regularly use, right down to nearly every EMT at all levels trying to educate themselves as much as they can, we all have to follow scope of practice that exists today, and if the best your scope of practice allows you to do is combitude, well then it's the EMT's duty to the patients, to train and educate themsleves so they know the complications, indications, anatomy and procedure to almost perfection...there have been some comments on how "easy" and i use the term loosely, it is to insert combitude, yes i agree it is a relatively "easy" procedure, but it still doesnt excuse the fact the we NEED to know the anatomy, contraindications, indications, and how fragile the airway just is, our job is to keep the pt. alive and to do nothing that causes our pt. further injury or harm...so we dont just ram or jam or whatever you wanna call it, a combitude down someones airway....and in all cases i would of thought, listening for lung sounds after placement was a given....EMT-B's in my opinion are well capable of performing these procedures, but it is each EMT-B's responsibility to ensure they KNOW exactly what they are doing....I hope all ALS providers would not generalise against EMT-B's, or EMT-I's just because of a few comments from a small number of EMT's they come across. in all fairness ive come aross paramedics at times when their actions could be questioned. but i dont generalise against all medics, everyone should be judged on their own merit....i'm sure if you rode some shifts with most of the EMT's here MOST of the medics would be happy with our patient care and treatment...instead or griping about what someone elses scope of practice is in their county or service, we should be sticking together and helping each other to overcome the obstacles that face improving the gold standard of care that WE all strive to achieve.
final point is...if your in this job and you feel like there is nothing more you can do to achieve a better standard of care for your patients and your complacent with the current standards, then maybe you need to reconsider your career choice, cos in every level of training from first aider right up to paramedic, there is always going to be something we all can do personally to improve our pt's "GOLD" standard of care.
final point is...if your in this job and you feel like there is nothing more you can do to achieve a better standard of care for your patients and your complacent with the current standards, then maybe you need to reconsider your career choice, cos in every level of training from first aider right up to paramedic, there is always going to be something we all can do personally to improve our pt's "GOLD" standard of care.