Anyone ever been denied an intubation during clinicals?

[Veneficus]

From my perspective, I'd pick a tied or 'field' traction splint over weights any time. I can control tension a lot more easily with a traction splint (manufactured or improvised) then I can with weights.

Keep it simple. Applies to a lot of stuff.

I like improvised with kling best. (rolled gauze) I appreciate having as few working parts as possible.

I don't like carrying heavy gear that rusts or has only one purpose.

 

[RocketMedic]

I really can't think of a great reason to use weighted splints for patient movement. That is not a good doctor decision.

 

[MedicPatriot]

Haha YES I had this happen quite often in my clinicals. A few doctors let me, a few didn't. I was a bystander on a 3 mo. old SIDS arrest and I asked the medic if I could get the tube (a preceptor I knew was on board). Just today I asked an ER doc if I could intubate after he did the RSI, and I'm an EMT-P done with clinicals. You have to get/retain the skills somehow, its not like we do it every day.

 

[usafmedic45]

I was a bystander on a 3 mo. old SIDS arrest

There is no reason we should be referring to a pediatric arrest as a "SIDS arrest". It's not SIDS until the pathologist has ruled out all causes of arrest. Most of them of what used to be classified as SIDS (you very seldom ever see it used anymore; most of them are just put down as "cause undetermined") are simply suffocation deaths because they parents are stupid enough to put the kid face down. "SIDS" is just a cop out and a way of making parents not feel so bad about effectively having killed their child. A lot of them should be rotting in jail for negligent homicide if you ask me.

 

[Veneficus]

There is no reason we should be referring to a pediatric arrest as a "SIDS arrest". It's not SIDS until the pathologist has ruled out all causes of arrest.

Or until the doc signs it on the death certificate on a patient not going to autopsy in order to save a family that made a terrible mistake because they didn't know any better from criminal prosecution.

 

[MedicPatriot]

There is no reason we should be referring to a pediatric arrest as a "SIDS arrest". It's not SIDS until the pathologist has ruled out all causes of arrest. Most of them of what used to be classified as SIDS (you very seldom ever see it used anymore; most of them are just put down as "cause undetermined") are simply suffocation deaths because they parents are stupid enough to put the kid face down. "SIDS" is just a cop out and a way of making parents not feel so bad about effectively having killed their child. A lot of them should be rotting in jail for negligent homicide if you ask me.

Well our protocols actually have a "SIDS" category in which this patient falls into so that's how I worded it.

You are right though, I have an inkling the mother rolled over on the baby in her sleep but that's just my thoughts.

Being flagged down for "the baby fell out" wasn't exactly what my vocabulary thought it would be.

 

[usafmedic45]

Or until the doc signs it on the death certificate on a patint not going to autopsy

No doc is allowed to sign off on that anymore unless there is a VERY lengthy medical history. The kid is going to get autopsied and there is going to be a police investigation. The case has to be reported to the coroner/ME as well as child protective services by law in every state. That death certificate isn't getting issued until the coroner OKs it. In fact, in most states, every death gets reported to the coroner/ME and the only time the death certificate is signed by the doc is if the coroner/ME declines the case.

save a family that made a terrible mistake because they didn't know any better from criminal prosecution.

Ignorance of the law or failure to know something that the prudent layperson would know is not a valid defense. My tolerance for "mistakes" is pretty low once said "mistake" starts claiming the lives of children.

 

[MedicPatriot]

Or until the doc signs it on the death certificate on a patient not going to autopsy in order to save a family that made a terrible mistake because they didn't know any better from criminal prosecution.

The other guy that commented is right though, its negligence. The really messed up part is that so many parents have no idea. I guess its mostly the uneducated.

 

[usafmedic45]

Well our protocols actually have a "SIDS" category in which this patient falls into so that's how I worded it.

Seeing as how Maryland's protocols have not seen a serious revision in this century, it doesn't surprise me that you guys are still using terminology from the 1980s and 1990s before people started realizing that most "SIDS" cases were either missed homicides or deaths due to negligence.

 

[MedicPatriot]

Seeing as how Maryland's protocols have not seen a serious revision in this century, it doesn't surprise me that you guys are still using terminology from the 1980s and 1990s before people started realizing that most "SIDS" cases were either missed homicides or deaths due to negligence.

Thank you! We just got Dexamethasone in our protocols this year. We're catching up to that standard of care thing little by little.

It isn't too bad in MD really. I just wish we had RSI.

 

[usafmedic45]

Thank you! We just got Dexamethasone in our protocols this year. We're catching up to that standard of care thing little by little.

No, you're not. The standard of care is so far ahead that as they throw one new thing at you every couple of years, fifteen other things that are still standards of care are even further behind.

It isn't too bad in MD really.

Yeah it is. I used to work there. The sad state of EMS in Maryland is the sole reason why I left there after I got out of the military. That said, I guess I owe those crotchety archaic :censored::censored::censored::censored::censored::censored::censored:s at MIEMSS a certain degree of thanks because otherwise I would not have the great girl who is reading this over my shoulder. My gratitude will be expressed by keeping the dancing and :censored::censored::censored::censored:ting on the grave of Robert Bass to a minimum once he dies.

 

[MedicPatriot]

No, you're not. The standard of care is so far ahead that as they throw one new thing at you every couple of years, fifteen other things that are still standards of care are even further behind.



Yeah it is. I used to work there. The sad state of EMS in Maryland is the sole reason why I left there after I got out of the military. That said, I guess I owe those crotchety archaic :censored::censored::censored::censored::censored::censored::censored:s at MIEMSS a certain degree of thanks because otherwise I would not have the great girl who is reading this over my shoulder. My gratitude will be expressed by keeping the dancing and :censored::censored::censored::censored:ting on the grave of Robert Bass to a minimum once he dies.

I was being sarcastic about the standard of care thing.

 

[EMTBHillbilly]

HA! You guys should try EMS in WV.

 

[STXmedic]

I don't think I want to try ANYTHING in WV.......