"Ambulance Attendants Sued"

[VentMedic]

Assuming, of course, that it even was an ET tube and not some type of multi-lumen airway.

When it comes to the airway, it doesn't matter what the tube is. It could be a Combitube, ETT, EOA, King or LMA. The EMS provider who is supposed to be trained for the device has an obligation to check placement.

If you say it is a Combitube, which can also cause serious damage, does not make you less liable if you fail to know what you are doing when attempting to secure an airway.

 

[medic417]

I missed reading down all the posts, sorry...was the first thing that I thought of, when I read the article!

Cheers Enjoynz

Me too. Would be neat to find more info on this case.

 

[ffemt8978]

When it comes to the airway, it doesn't matter what the tube is. It could be a Combitube, ETT, EOA, King or LMA. The EMS provider who is supposed to be trained for the device has an obligation to check placement.

If you say it is a Combitube, which can also cause serious damage, does not make you less liable if you fail to know what you are doing when attempting to secure an airway.

My point was that if it was a multi-lumen, perhaps it was in the esophagus, but that doesn't mean it was incorrectly placed, and it doesn't mean that her brain damage was the result of tube placement.

How do you differentiate between the patient's injuries secondary to inadequate care, and her injuries secondary to her vehicle accident? Especially when you consider she was knocked unconscious with

... allegedly suffered multiple injuries, including a traumatic head and brain injury

If the attendants made a mistake, then they should be held accountable for it. However, we do NOT know that this is the case in this situation.

 

[VentMedic]

My point was that if it was a multi-lumen, perhaps it was in the esophagus, but that doesn't mean it was incorrectly placed, and it doesn't mean that her brain damage was the result of tube placement.

So you think you just shove in a tube meant for the esophagus and it is idiot proof?


Let me rephrase this one more way.

A lacerated spleen can be removed.
A lacerated diaphragm can be repaired.
It is riskier for a pregnant woman because of the anesthesia and how it will affect the baby but both problems can be dealt with.

Hypoxia permanantly damages the brain and other organs. It can also cause death.

You can debate the article all you want. But cockiness in thinking something is fool proof or serious injuries can not happen is what gets EMS providers into problems. You can attempt to blow off whatever other problems but if the tube was misplaced, regardless of the other injuries, that did the irreversible damage. That should be brought out when the case is presented. Trying to smoke screen your own screw up won't release you from some responsibilty. This news article may not have presented all the facts but the one statement that was presented was a misplaced tube and was responsible for oxygen deprivation. The other injuries can be disputed but her surgeons will make those points. All I did was describe how some of these injuries can occur by discussing the LENGTH of an ETT and the diaphragm/organ displacement of a pregnant woman. I did that because some appeared to not know their equipment very well or understand what happens during pregnancy.

Often, for many complications that occur from ETI, it is just taken as a complication of rescue. The trach or laryngectomy fixes whatever screw ups some providers do when intubating. We have medical helicopters with advanced providers that can quickly move a patient from one hospital to another for a tracheal and esophageal repair by open chest. These problems can be fixed but unless they are recognized, the results of hypoxia can not be fixed.

For those who think the combitube is idiot proof.
http://pdm.medicine.wisc.edu/21-2%20PDFs/calkins.pdf

 

[ffemt8978]

Vent, I actually agree with you. My point of contention is the lack of information in the article, that's all.

 

[VentMedic]

Vent, I actually agree with you. My point of contention is the lack of information in the article, that's all.

When articles are vague like this, there is still much information that can be used in discussion to learn something from it to make one a better healthcare provider and not a lawyer.

At least now some will know how long an adult ETT is.

 

[medic417]

So you think you just shove in a tube meant for the esophagus and it is idiot proof?

For those who think the combitube is idiot proof.
http://pdm.medicine.wisc.edu/21-2%20PDFs/calkins.pdf

Wow 16-28% failure rate depending on how you look at it. Regardless not really that good a percentage of success. Plus damages to the patient with it. Really need that out of the basics hands, and even from the lesser educated Paramedics.