Co2

[trauma1534]

You know, we discuss things, put in our two cents and listen to what others have to say. No where in the world does it say you have to listen and be bitter about my disagreeing with you. It will happen. People disagree all the time.

Again, just because I don't like that doesn't mean that you can't do it. take it in stride. Don't be so bitter about it. It's not that big of a deal.

Lots of times we must do things in the field that we don't like. Intubation is not a matter of weather you like it or not, it is a necessity tool of the trade! If you are an I and don't find it important enough to secure your patient's airway, then you might as well drop back to a B, however EMT-B's intubate also... I guess that would mean that you would need to be a First Responder so that you would not have to be held responsable for intubations.

By the way... how long have you been in EMS and how long have you been an ALS provider? Just curious...

 

[Ridryder911]

Lots of times we must do things in the field that we don't like. Intubation is not a matter of weather you like it or not, it is a necessity tool of the trade! If you are an I and don't find it important enough to secure your patient's airway, then you might as well drop back to a B, however EMT-B's intubate also... I guess that would mean that you would need to be a First Responder so that you would not have to be held responsable for intubations.

By the way... how long have you been in EMS and how long have you been an ALS provider? Just curious...

Actually intubation is NOT part of the national Basic EMT curriculum. As well there are more states that do NOT allow Basics to intubate than allow them to. That is why they are called basics... other wise most would call them advanced.
I am curious though when you intubate how long to do you pre-oxygenate prior to intubation attempts?
p.s.... weather is a meteorological term ..lol

R/r 911

 

[Guardian]

Lots of times we must do things in the field that we don't like. Intubation is not a matter of weather you like it or not, it is a necessity tool of the trade! If you are an I and don't find it important enough to secure your patient's airway, then you might as well drop back to a B, however EMT-B's intubate also... I guess that would mean that you would need to be a First Responder so that you would not have to be held responsable for intubations.

By the way... how long have you been in EMS and how long have you been an ALS provider? Just curious...

There you go again trying to portray yourself as an expert because you have more "experience" than some other people on this forum. Is it possible for a John Doe MD, FACS, FACEP, PH.D, MS, MS, MS, CCRN, CCEMT-P, FP-C, MICP, to have a debate with Jane Doe (attending CPR class) and lose that debate to her because he's wrong? YES!!!!!

 

[Ridryder911]

If it is solely based upon experience.. I am afraid my resume and bad knees and back might win... I will be celebrating my 30'th year in the field this coming year. Anyone want to compare Registry numbers ? LOL ...

R/r 911

 

[Airwaygoddess]

Wait! I hear the sound of stone tablets and Rid's turbo charged wheelchair! ^_^ Just teasing, I agree that ET intubation is an ALS skill. One must understand the theory behind the skill. So Rid, how many numbers on your parmedic cert?

 

[ffemt8978]

So Rid, how many numbers on your parmedic cert?

My guess is one...I heard he worked his first code on the Ark.

 

[Ridryder911]

Yeah, my first drowning victim...LOL I put it this way my original card was less than 10,000 for my basic registry. (Remember NREMT did not have a Paramedic level until 1982) So everyone took the NREMT- A (ambulance) and then took a Paramedic course and maybe a local Paramedic test.. wham you were a Paramedic.

They changed everyone Paramedic numbers about 10 years ago so there is no low numbers any more.

Funny, I am not that old.. I just started when I way too young. (seriously) I had performed my first code in the field & defib when I was 16. We were two of the only Paramedic services in the state. So bringing a patient in to an ER with an IV was never heard of. There was fights among nurses and EMT's all the time (ironic most of the nurses in ER were LPN's).

We have came great strides in some areas and still lacking in others.. that is why I am so passionate in getting things changes. I never want to see us regress. Many people have paid multiple of sacrifices to have EMS where it is today...

R/r 911

 

[fyrdog]

While ET tubes are a tool of the trade I disagree that they are a necessity. I was working with another paramedic one day on a code and he said he didn't know if the tube was in right but kept it in and used it. I got him to switch with me so I could double check it and ended up pulling it because it was definitly not in. I wasn't able to be sure 100% I could get it either so we ended up with an OPA and BVM. He had chest rise and lungs sounds with the BLS airway not with the ET tube. Neither one of us heard anything bad about our descion expecially since aneistesia had a heck of time getting it in the ER.

I was taught that a BLS airway is better than an uncertain ET Tube.


Sorry about all the spellin errors.



Ridryder911 didn't you do that water rescue with that little kid in reed basket? I think his name was moses.

 

[Guardian]

While ET tubes are a tool of the trade I disagree that they are a necessity. I was working with another paramedic one day on a code and he said he didn't know if the tube was in right but kept it in and used it. I got him to switch with me so I could double check it and ended up pulling it because it was definitly not in. I wasn't able to be sure 100% I could get it either so we ended up with an OPA and BVM. He had chest rise and lungs sounds with the BLS airway not with the ET tube. Neither one of us heard anything bad about our descion expecially since aneistesia had a heck of time getting it in the ER.

I was taught that a BLS airway is better than an uncertain ET Tube.


Sorry about all the spellin errors.



Ridryder911 didn't you do that water rescue with that little kid in reed basket? I think his name was moses.

sounds like you needed capnography in this case.

 

[jeepmedic]

Actually intubation is NOT part of the national Basic EMT curriculum. As well there are more states that do NOT allow Basics to intubate than allow them to. That is why they are called basics... other wise most would call them advanced.
I am curious though when you intubate how long to do you pre-oxygenate prior to intubation attempts?
p.s.... weather is a meteorological term ..lol

R/r 911

No one said anything about the National Curriculum. Also Intubation is taught in the Basic Class look in the EMT-B books. It is included in the back of the books as an add on. Also Basic Intubation is included in Virginia as an OMD option. Which means that if the OMD approves then an EMT-B can be taught intubation. Which is also the case for a Combi-tube.

As far as pre-oxygenating a pt prior to intubation it is 30-60 sec. and if you can't tube them within 20-30 sec. then you pull out and oxygenate them again for 30-60 sec.

Who cares about the weather? lol

 

[jeepmedic]

Yeah, my first drowning victim...LOL I put it this way my original card was less than 10,000 for my basic registry. (Remember NREMT did not have a Paramedic level until 1982) So everyone took the NREMT- A (ambulance) and then took a Paramedic course and maybe a local Paramedic test.. wham you were a Paramedic.

They changed everyone Paramedic numbers about 10 years ago so there is no low numbers any more.

Funny, I am not that old.. I just started when I way too young. (seriously) I had performed my first code in the field & defib when I was 16. We were two of the only Paramedic services in the state. So bringing a patient in to an ER with an IV was never heard of. There was fights among nurses and EMT's all the time (ironic most of the nurses in ER were LPN's).

We have came great strides in some areas and still lacking in others.. that is why I am so passionate in getting things changes. I never want to see us regress. Many people have paid multiple of sacrifices to have EMS where it is today...

R/r 911

I thought you said you were never an EMT, that you were always a Paramedic.

 

[trauma1534]

I thought you said you were never an EMT, that you were always a Paramedic.

Nope... not Ridryder... NEVER an EMT!!! That would be a discrase on his part for anyone to ever be able to figure out that he was not always the seen all known all Paramedic, NP, and whatever else his merrit badges says!!! LOL

 

[Guardian]

it's disgrace

 

[macinfire]

Our capnography is on our Zoll's, we should use it more often... We had several really good classes when we first got it, but we need a refresher. For us, just another tube placement indicator. I know if I have a good visual, then most of the time I don't bother, unless it may be a prolonged tx, which is rare in the city I am in.

 

[jeepmedic]

Our capnography is on our Zoll's, we should use it more often... We had several really good classes when we first got it, but we need a refresher. For us, just another tube placement indicator. I know if I have a good visual, then most of the time I don't bother, unless it may be a prolonged tx, which is rare in the city I am in.

We still have to use the little color change thingie even though you should not place the tube without cord visulazation and poss. lung sounds without epigastric sounds.

 

[Ridryder911]

The "colored thingie" I presume is a colorimetric capnograhic device. The nice thing they are cheap and do work most of the time. The down side is that they are not effective if the patient has vomited, has ingested beer, cola, or has large amount of fluid in the lungs.. as well does not represent levels of EtCo2 and if there is obstruction versus retention levels.

p.s. everyone that wanted to be NREMT had to take the EMT-Ambulance or non-ambulance test. There was not a NREMT Paramedic exam until 1980. One could already be a Paramedic though through local and state license/ certification prior to NREMT invention of levels. The intermediate was later designed in 1981.

R/r 911