Is an ET Tube Really ALS?

[VentMedic]

Okay, and that's perfectly fine. I respect your opinion as a paramedic. However, I follow the protocols set by my squad medical director who just so happens to be an MD that doesn't have any issues with it.^_^

One more time...

By your protocols, are you intubating only the pulseless patient that is a "code"? Or, a patient that could also tolerate a King or Combitube in respect to absent gag?

 

[mikeylikesit]

One more time...

By your protocols, are you intubating only the pulseless patient that is a "code"? Or, a patient that could also tolerate a King or Combitube in respect to absent gag?

And Vent's opinion is more than just from a paramedic...RRT Registered Respiratory Therapist.

 

[Ridryder911]

I am a paramedic student and to be honest if a basic is competent enough then why not let them drop an ET. Its really not that big a deal and paramedics who forget that the basic and medic are a team and the medic cannot do his/her job without a competent basic needs to retrained and remember that its BLS b4 ALS.

Spoken just a like an individual that does not understand medicine. Show me a Paramedic that forgets the so called "basics" and I will show you ten Basics that can't find their way home.. C'mon, do you really, really think anyone would forget anything so simple as the basics... duh! That is why they are called such!.... Do you forget the "basics", why would a Paramedic forget because they have learned more? So this means when a Basic forgets the basic, they do nothing?

Besides there is NO SUCH THING AS BASIC or ADVANCED!! Rather there is full care or inadequate care.!


R/r 911

 

[VentMedic]

Yeah, and I also work for a couple of medical directors who also have MD behind their name. They prefer the people they are overseeing have the best possible education, training, access/experience to alternative equipment and abilities to keep them (the providers AND the MDs) from answering the questions from my previous post in front of administrators and attorneys.

We don't take intubation lightly. One should respect it as a lifesaving skill but also know it can cause death and disability. It should not be viewed with the attitude of "just another skill because I can".

How many times has your Medical Director personally seen you intubate a live patient? Or personally checked any of your competencies?

Regardless of one's title, be it RRT, MD, DO, NP, PA or RN, they do not get intubation privileges easily at our hospitals. The same for Flight and CCT. They must repeated show their knowledge and skills.

 

[wolfie23b]

I have done plenty of Intubations, "What happens in the back of a rig, stays in the back of the rig." You may operate just fine w/o a basic emt in YOUR rig but a paramedic that forgets the value of a competent basic is a paramedic that is gonna get someone hurt. The Basic is what rminds the Paragod that IT ALL STARTS WITH BLS. And too many paramedics, or shall I say "Paragods" seem to jump straight to their cool machines and drugs b4 they do the simple tasks. Treat the Pt not the monitor.

 

[wolfie23b]

your posts have always gotten me up in arms because its RN's like you that think they no everything there is to know. There are plenty of PARAGODS out there and they don't belong on MY rig.

 

[VentMedic]

your posts have always gotten me up in arms because its RN's like you that think they no everything there is to know. There are plenty of PARAGODS out there and they don't belong on MY rig.

First
I am not an RN.
That was even spelled out in a previous post by mikeylikesit.

Second

What's with the attitude about Paragods and no EMT or EMT-Ps in the back of the truck? This thread is about competency for intubation.

Third

"What happens in the back of a rig, stays in the back of the rig."

That comment has no business being in your vocabulary. For one it will give anyone, layperson or other HCWs, the WRONG impression about your competency and will start to question your charting. Your partner may not be as willing to lie for you as you think especially if it also jeopardizes their license.

It is very easy to do a direct visualization to determine how much damage is done by intubation. Of course, when the patient is extubated and has no vocal cord function, that also is a good indicator that things may not have gone smoothly.

Fourth

drugs b4 they do the simple tasks.

This statement definitely indicates that you have little understanding about intubation.

 

[wolfie23b]

i won't dignify with a response, I know my skills and know that I for one can do the skill at hand. I also know that a combi tube can do just as much damage and basics in my state are getting the ok to do those so what is reall the difference. I do not beleive that any part of my comment was out of line or that it can be mis construde about my skills. I graduate Paramedic scool in a couple of weeks and I am a very competent medic. I have been a basic since 1992 and Loved every bit of it, and still learn something new everyday.

 

[VentMedic]

i I graduate Paramedic scool in a couple of weeks and I am a very competent medic.

None of your remarks so far have indicated any advanced training or education. You will continue to use the skills you practiced as an EMT but you will also have to assess and treat at a higher level as a Paramedic.

Are the Paramedics in your area not allowed to premedicate with anything prior to intubation, or after, if the patient is even somewhat awake? Was this not covered at all in Paramedic school?

For clarification, I am not talking about RSI.

I see nothing wrong or "Paragod" about being concerned for patient safety and ensuring the best possible care has been provided.

 

[JPINFV]

I have done plenty of Intubations, "What happens in the back of a rig, stays in the back of the rig." You may operate just fine w/o a basic emt in YOUR rig but a paramedic that forgets the value of a competent basic is a paramedic that is gonna get someone hurt. The Basic is what rminds the Paragod that IT ALL STARTS WITH BLS. And too many paramedics, or shall I say "Paragods" seem to jump straight to their cool machines and drugs b4 they do the simple tasks. Treat the Pt not the monitor.

Holy cliche Batman!

1. Your patient does not stay in the back of your ambulance. That patient represents your care and the quality of that work. Therefore, your performance most definitely does not stay in your unit.

2. It all starts with patient care. An EMT-Paramedic who fails at delivering the basics of patient care will fail regardless of who else is in the back of the unit. It does not matter who is or isn't in the back of the unit and has absolutely nothing to do with EMT-Basics. A provider's education should be what's reminding them of basic care.

3. Who reminds a physician to provide basic patient care? As an alternative, are you just insinuating that all paramedics are idiots?

4. Sorry, but not all patients follow a continuum that goes from basic procedures to advanced procedures. Some patients need advanced procedures immediately.

 

[Ridryder911]

i won't dignify with a response, I know my skills and know that I for one can do the skill at hand. I also know that a combi tube can do just as much damage and basics in my state are getting the ok to do those so what is reall the difference. I do not beleive that any part of my comment was out of line or that it can be mis construde about my skills. I graduate Paramedic scool in a couple of weeks and I am a very competent medic. I have been a basic since 1992 and Loved every bit of it, and still learn something new everyday.

Are you really sure about what you say? Do I see you at the EMSAC, ORSAC and State EMS Advisory Meetings or are you just the typical EMT that shows up for work and do whatever is allowed at the time? As well are you sure about comments you made the combitube, or are you just pulling this and other stuff from your arse? Please back it up with citations and references of medical literature, otherwise it's just ignorant rambling.

You might be graduating from Paramedic school in a couple of weeks ( I would like to know from where?) but you still can't even spell it ? C'mon!



R/r 911

 

[Ridryder911]

your posts have always gotten me up in arms because its RN's like you that think they no everything there is to know. There are plenty of PARAGODS out there and they don't belong on MY rig.

Just remember, it is Paragods and RN's like me that wrote your legislation for a license to work, as well a Paragod & RN that wrote the trauma diversion to allow patient to be taken the most appropriate facility instead of the nearest which cost needless deaths, as well as developing the regulations and establishing Trauma Centers in OK.

As well it is the RN & Paragods that continue to fight for you to have death & injury benefits in your state and funding for your EMS to function..to be able to be in that so called "rig".....

It as well those you would love to be able to work with on a helicopter or in that " rig " with... and will either hire you or not....

So from one of those, your welcomed.

R/r 911

 

[BEorP]

I can't even believe this thread... I may save the link for anyone who asks why American EMS will never reach the level of professionalism that is generally seen in Ontario.

 

[mikeylikesit]

I can't even believe this thread... I may save the link for anyone who asks why American EMS will never reach the level of professionalism that is generally seen in Ontario.

LOL, oh no just see the EMT education and Do we need EMT posts.

 

[Ridryder911]

I can't even believe this thread... I may save the link for anyone who asks why American EMS will never reach the level of professionalism that is generally seen in Ontario.

I do wished we required the same entry and educational requirements. If we did we would not have a Paramedic course taught at a trade school, and most would be able to understand general medicine as well have a literacy rate level above the elementary level.

As well, I assume that most of your fellow Countrymen understands the local and regional laws and regulations. I have seen and discussed the difference with many from Canada and do wish we could implement similar requirements and standards.

R/r 911

 

[Ridryder911]

I want to apologize for my blasting on my previous posts. Not excusable but I have just spent most of the day fighting for raises for EMS personnel. I have been describing how we are educated and it is only justifiable to have professionals to be paid as such..

It is hard to make a point to only to be proved wrong..

R/r 911

 

[reaper]

I have done plenty of Intubations, "What happens in the back of a rig, stays in the back of the rig." You may operate just fine w/o a basic emt in YOUR rig but a paramedic that forgets the value of a competent basic is a paramedic that is gonna get someone hurt. The Basic is what rminds the Paragod that IT ALL STARTS WITH BLS. And too many paramedics, or shall I say "Paragods" seem to jump straight to their cool machines and drugs b4 they do the simple tasks. Treat the Pt not the monitor.

You have not even started working as a medic and you have this attitude already? You have not even come close to doing ENOUGH intubations, to understand what most are talking about. You need to step back and keep learning from those that have the experience. Once you think you are good enough, it will all go down hill from there!!

 

[Ridryder911]

Intubation is a NREMT-B skill.

Just a clarification.. Intubation is NOT a NREMT-B skill nor an NREMT-I (89) skill. Some states do add intubation to their respective certifications or license levels, however; this is NOT an NREMT guideline.

R/r 911

 

[Jon]

Just a clarification.. Intubation is NOT a NREMT-B skill nor an NREMT-I (89) skill. Some states do add intubation to their respective certifications or license levels, however; this is NOT an NREMT guideline.

R/r 911

Time out - so why was it in the back of my EMT-B text as an "optional module"... I thought that was what the national standard had it as.

 

[traumateam1]

To answer the question, yes I think that an ET Tube, or intubation is ALS.