Esophageal Airway

[cfrench]

No matter what was wrong, a line with D5W, 1 amp of Bicarb and a 100mg Lidocaine bolus followed by a drip at 2mgs/min would fix it.

And don't forget, the IV has to be in a glass bottle

 

[foxfire]

No matter what was wrong, a line with D5W, 1 amp of Bicarb and a 100mg Lidocaine bolus followed by a drip at 2mgs/min would fix it.

Seriously ? Wow

 

[NomadicMedic]

I loved emergency as a kid. It's on Hulu.com now. I watch it when I'm bored.
Some of the gems; 2 amps of bicarb for arrests, intracardiac epi, EOAs, and shocking every patient back into NSR. If only it were that easy now.

 

[Veneficus]

I too remember to day of doing mouth to mouth, stopping long enough to spit the pt's vomit from your mouth and then continuing, I remember using the EOA, always had a problem with snapping the mask in place and ,holding a good seal, Is it not blasphmy to work in ems or the fire service and have NO knowledge of John G and Roy D,this should be required watching material, even though sodium bicarb is no longer a front line drug.

Johnny and Roy helped inspire my career, but i think missing out on mother, juggs, and speed would be more unholy.

 

[Akulahawk]

Mother, Juggs, and Speed? Missing out on that is the definition of unholy! Missing it is MOST Blasphemous!

 

[jjesusfreak01]

My instructor pulled out both of these retro airways during my EMT class. He also did a class on picc lines, ostomies, shunts, etc...he wanted us to not be surprised with anything.

 

[JJR512]

And every patient on Emergency! always survived if they were treated by Johnny and Roy...unless it made a dramatic, or more importantly a sociological commentary point, to have the pt. die.

 

[MasterIntubator]

I never found the EOA to be particularly useful.

I would have to disagree... I found the EOA a wonderful device for the time. Having placed numerous of them... they gave me great frustration in maintaining a good facial seal( good for training skills ), allowed copious useage of Kentucky Jelly ( which I always loved lubing up ), it plugged the puke hole so nothing would ever come out, it was nice to intubate around, it provided a great bite block for the ETT, it gave you something else to do while doing CPR in the checkout line at a grocery store to look cool for the crowds watching ( just under flipping the abboject caps off and defib with paddles with the lifepak 4/5. ) and it came in a great big, space occupying white and yellow box that no one can miss.

Just about everything just short of good ventilation. :blush: :wacko:

 

[abckidsmom]

I would have to disagree... I found the EOA a wonderful device for the time. Having placed numerous of them... they gave me great frustration in maintaining a good facial seal( good for training skills ), allowed copious useage of Kentucky Jelly ( which I always loved lubing up ), it plugged the puke hole so nothing would ever come out, it was nice to intubate around, it provided a great bite block for the ETT, it gave you something else to do while doing CPR in the checkout line at a grocery store to look cool for the crowds watching ( just under flipping the abboject caps off and defib with paddles with the lifepak 4/5. ) and it came in a great big, space occupying white and yellow box that no one can miss.

Just about everything just short of good ventilation. :blush: :wacko:

Oh, the lifepak 5! I loved watching that needle bounce around as it recorded artifact for at least the next week or two before the paper faded!

One of the first arrests I can remember was a drunk guy who dove off a platform into 2.5 feet of water. We had a 20 minute response time, and got on scene to find a bunch of drunk guys doing CPR, on that platform out in the water. We hoisted the bag and the monitor and the drug box up overhead and splashed on out there.

We were really herioc bag then. And completely effective! That guy even had the helicoptor called for him, another 20 or so minutes later. IVR was the gift that kept on giving.

In my defense, I was a junior...not in charge, and I only remember this call as an illustration for how much money and time was wasted on people without a hope.

 

[Veneficus]

I would have to disagree... I found the EOA a wonderful device for the time. Having placed numerous of them... they gave me great frustration in maintaining a good facial seal( good for training skills ), allowed copious useage of Kentucky Jelly ( which I always loved lubing up ), it plugged the puke hole so nothing would ever come out, it was nice to intubate around, it provided a great bite block for the ETT, it gave you something else to do while doing CPR in the checkout line at a grocery store to look cool for the crowds watching ( just under flipping the abboject caps off and defib with paddles with the lifepak 4/5. ) and it came in a great big, space occupying white and yellow box that no one can miss.

Just about everything just short of good ventilation. :blush: :wacko:

Clearly I underestimated its value.

 

[MonkeySquasher]

Heh... NYS requires Medics to still be trained in EOA/EGTA, Combitube, LMA< and other obsolete airways. We also train on both old and newer monitors.

I belong to two services, one uses LP12, the other Zoll M. And I still think the LP10 is one of the best monitors ever. Simple, effective, very straightforward, has paddles but can convert to handsfree.

 

[NomadicMedic]

And I still think the LP10 is one of the best monitors ever. Simple, effective, very straightforward, has paddles but can convert to handsfree.

I'm guessing you don't do 12 leads. (Unless you do the old MCL trick.)

 

[usalsfyre]

Heh... NYS requires Medics to still be trained in EOA/EGTA, Combitube, LMA< and other obsolete airways. We also train on both old and newer monitors.

I belong to two services, one uses LP12, the other Zoll M. And I still think the LP10 is one of the best monitors ever. Simple, effective, very straightforward, has paddles but can convert to handsfree.

Considering that tomorrow out of all the patients placed under general anesthesia the majority will have a LMA placed to facilitate ventilation and provide airway protection I'm not sure I'd consider it "obsolete".

I miss the LP10 sometimes. You could nearly run over the darn thing and not break it. However I can't say the 12 isn't a superior diagnostic device. I never did like paddles though.

 

[MEDIC802]

One service I work for uses the Zoll E series with all the bells and whistles, the other service still uses the LP 10, but that finally gonna change, state is gonna require 12 leads and ability to transmit on all ALS transport units by end of year.
The first monitor I ever used was an MD3.

 

[MonkeySquasher]

Considering that tomorrow out of all the patients placed under general anesthesia the majority will have a LMA placed to facilitate ventilation and provide airway protection I'm not sure I'd consider it "obsolete".

You're right, I'm sorry, I didn't specify. The LMA is obsolete as a pre-hospital airway. It is useful as a temporary airway in a stable environment, but has too many contraindications and doesn't protect the airway well enough for an emergency airway, IMO.

The others are obsolete due to advancements and improvements.

And you're right, the LP10 can't do a 12-lead, nor ETCO2 or SPO2... But it's a great monitor.

 

[JLMooreKCMO]

Ahh yes, the "airway" that still required the user to maintain a mask seal. Good times...

I actually used them all the time in the 80's worked quite well. The Paramedics in CA could not intubate until sometime in the 90's but yet had the highest save rate in the country, probably due to time & preventing aspiration.I could insert an EOA in about 3-5 seconds. As far as seal they were made with a extremely plyable material seal was never a problem.

 

[Handsome Robb]

You're right, I'm sorry, I didn't specify. The LMA is obsolete as a pre-hospital airway. It is useful as a temporary airway in a stable environment, but has too many contraindications and doesn't protect the airway well enough for an emergency airway, IMO.

The others are obsolete due to advancements and improvements.

And you're right, the LP10 can't do a 12-lead, nor ETCO2 or SPO2... But it's a great monitor.

I might be wrong but don't most services in Australia use the LMA at the ILS level. I know ICPs can intubated but I don't think their standard Paramedics can. If I'm not mistaken about this whole thing they seem to work fine for them otherwise they wouldn't use them anymore...with that said, there's a TON we can learn from those Auzzies and Kiwis when it comes to EMS

 

[Carlos Danger]

You're right, I'm sorry, I didn't specify. The LMA is obsolete as a pre-hospital airway. It is useful as a temporary airway in a stable environment, but has too many contraindications and doesn't protect the airway well enough for an emergency airway, IMO.

The others are obsolete due to advancements and improvements.

And you're right, the LP10 can't do a 12-lead, nor ETCO2 or SPO2... But it's a great monitor.

I'm curious which contraindication you refer to that don't apply to other SGA's, and also which other SGA protects the airway better than an LMA?

I definitely wouldn't call the LMA obsolete. And it most certainly doesn't belong in the same category as the EOA and Combitube.....even if for no other reason than that it's still widely used.

You might be able to make a good case that the King or another SGA is better for general prehospital use for some reason, and that's fine, but the LMA is a great tool that remains the standard against which all other modern SGA's are measured.

Personally, an intubating LMA will probably always be my backup airway for an emergent situation, whether I'm in the ambulance, the helicopter, or the OR. At least until I'm convinced that something else is better.

 

[Flight-LP]

I'm curious which contraindication you refer to that don't apply to other SGA's, and also which other SGA protects the airway better than an LMA?

I definitely wouldn't call the LMA obsolete. And it most certainly doesn't belong in the same category as the EOA and Combitube.....even if for no other reason than that it's still widely used.

You might be able to make a good case that the King or another SGA is better for general prehospital use for some reason, and that's fine, but the LMA is a great tool that remains the standard against which all other modern SGA's are measured.

Personally, an intubating LMA will probably always be my backup airway for an emergent situation, whether I'm in the ambulance, the helicopter, or the OR. At least until I'm convinced that something else is better.

This!

I'd take an LMA Supreme over a King any day.

 

[Rayon]

Emergency (TV show)

Interestingly enough I am currently watching an episode of this show (via Netflix btw) and I too was wondering what they were referring to as the Esophogeal Airway. A google search landed me on this forum.

Emergency (the show) was popular back in the early to mid 70's, so that's when I watched it. The good news for you buffs out there you can watch it ad naseum via Netflix. =-D

I assumed they meant the old EOA or EGTA, but wanted to see if there was something specifically tied to "Esophogeal Airway".

Anyway that's my 2 cents.