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Oh crap there goes the neighborhood.
Good to see you back brother
Good to see you back brother
Blakemore tubes?
- Thread starter blindsideflank
- Start date
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Intubating LMA is awesome. I personally much prefer the Air-Q over the Fastrach. I've placed many of both types, and intubated through them a few times.
The i-gel is supposed to be the shiznit, but I have yet to use it except on a manikin.
I have no clue why the ILMA hasn't gained more popularity in EMS. They are great devices and have probably done more to (virtually) eliminate emergent crics in the hospital than anything else.
In the setting of a massive GI bleed, an ILMA would be very appropriate IMO.
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VFlutter
Flight Nurse
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RNs are taking over the thread! :rofl:
mycrofft
Still crazy but elsewhere
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KingCountyMedic
Forum Lieutenant
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I haven't touched a scalpel since we started carrying the I-Gel, one of the best tools ever.
Ridryder911
EMS Guru
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Fortunately; I've only worked a few ruptured esophageal varices in the field and alike what is most discussing without really saying it; it's a no win situation. I have never seen a small bleed varices and looking at post cadavers with them I could understand why. This is why I cautious or refuse to place an NG/OG tube in high risk patients, (alcoholic; GI bleeds).
Let's visualize this patient, they have copious amount of bleeding, their vomiting, gurgling, and the suction units containers are filling up pretty fast. Not only an airway problem but they are bleeding and going into shock as well.
One might say they would immediately crich a patient. Technically I would not disagree on of these cases. Some of the problems I have encountered on these presentations is locating visualize landmarks on those that are obese, that have anterior or no-neck type and to make things worse is the large amounts of blood that is is usually associated. Even performing a crich can cause some moderate bleeding (especially that are diluted with ETOH or on anticoagulants)
Unless you really can occlude the esophagus with some type of occluding device, chances of visualizing the glottic opening is very low; no matter what device you use to intubate.
In regards with LMA alike with combitubes; it might be worth a try; again since it's the airway from HE*L, and at this point .... would it hurt? I have used them on those with profuse vomiting and bleeding.
One can only do what they can at the time. Airway compromise, bleeding that cannot be controlled, one can easily predict the outcome.
R/r 911
Let's visualize this patient, they have copious amount of bleeding, their vomiting, gurgling, and the suction units containers are filling up pretty fast. Not only an airway problem but they are bleeding and going into shock as well.
One might say they would immediately crich a patient. Technically I would not disagree on of these cases. Some of the problems I have encountered on these presentations is locating visualize landmarks on those that are obese, that have anterior or no-neck type and to make things worse is the large amounts of blood that is is usually associated. Even performing a crich can cause some moderate bleeding (especially that are diluted with ETOH or on anticoagulants)
Unless you really can occlude the esophagus with some type of occluding device, chances of visualizing the glottic opening is very low; no matter what device you use to intubate.
In regards with LMA alike with combitubes; it might be worth a try; again since it's the airway from HE*L, and at this point .... would it hurt? I have used them on those with profuse vomiting and bleeding.
One can only do what they can at the time. Airway compromise, bleeding that cannot be controlled, one can easily predict the outcome.
R/r 911
rwik123
Forum Asst. Chief
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The box contraindications along with my local protocols contraindicate king use with known esophageal disease. Just food for thought.