Prehospital ET Intubation

EMS14

EMS14

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I am writing a decent sized research based paper for my composition class. I decided that I would like to discuss the issue of intubations (specifically ET) in the prehospital realm by paramedics, advocating, of course, for the medics :). I was wondering if there are any sort of "industry standards" as far as articles concerning this. I have already found a couple of articles. I am just looking for more research (on either side). Through my school, I have access to nearly every database and journal so just a title would probably do it. I could retrieve it myself later. Thanks a bunch!
 
Google it my friend. There are many article's for and against..................
 
EMS14 said:
I am writing a decent sized research based paper for my composition class. I decided that I would like to discuss the issue of intubations (specifically ET) in the prehospital realm by paramedics, advocating, of course, for the medics :)
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Remember, it is not really a research paper if it is already biased...Perform the research, and then make the conclusion. You may be surprised that your views may change or be altered, or maybe strengthened.

Like Flight described, Google and look up literately references.
Good luck,
 
I feel ya EMS14; I am in composition as well and frequently do papers in regards to EMS. Here are a few places where I gather my results(dont forget to give proper biblio or works cited; comp teachers dont take kindly to it, lol)

Journal of EMS: http://www.jems.com/index.html
EMS Magazine: http://www.emsresponder.com
PubMed: http://pubmed.gov

You might want to login to your college's library. Most libraries provide students with access to subscription databases, and other sources deemed "Trusted".
If you are unsure as to how to access your library's system; I would urge you to contact the librarian for help.

Also, if you are ever in need of a good topic--this forum provides some pretty lively debates in regards to what's currently happening in EMS. Good luck on your research. (hope those correlation coefficients don't bite you in the butt like they do me.)
 
Ridryder911 said:
Remember, it is not really a research paper if it is already biased...Perform the research, and then make the conclusion. You may be surprised that your views may change or be altered, or maybe strengthened.

Like Flight described, Google and look up literately references.
Good luck,
Click to expand...

it is actually a researched based academic argument officially
 
I don't have much else to offer, but I'll admit that I was absolutely shocked each month when I reviewed our QI reports and saw the number of misplaced ET tubes and unsuccessful IV attempts.
 
I realize now that my original post may have made me sound incredibly lazy asking you to do all of the research work for me. This is not what I intended. What I really wanted to know if there is any one individual or group that is a major proponent of no prehospital intubations and if there is an individual or group that is a major proponent of prehospital intubation. Probably a bad example but.. like the EPA would be in favor of no drilling in the wilderness, and oil company would be, and they would have their different reasons. Thanks.
 
Pediatric ETI has been taken out of the protocols for some agencies.

http://jama.ama-assn.org/cgi/content/full/283/6/783


http://www.medscape.com/medline/abstract/16713780

http://www.merginet.com/index.cfm?pg=airway

At the bottom of the articles are more references.

There is not a particular group against paramedic intubations nor is there an "organized" group for paramedic intubation. Paramedics all have their opinions and want to keep their skills. But due to a lack of initial training foundation for some (particularly in peds) and a lacks of skills maintenance or competency monitoring for others as well as the vast array of "intubation certifications" at the many EMS levels, the effort is difficult.
 
JEMS is always a good source, we normally have a bunch of issues sitting around our stations. Also, checking your ALS Standards will have some (background) information on it, might not be too useful in writing the paper (except perhaps in an intro), but good to review nonetheless. If you can't get a copy of your local ALS Standards (or equivalent) I can send you the Ontario one, but there's probably some minor differences.
The ( British Medical Journal has some interesting articles, though I don't know if there's anything relevant to your paper off the top of my head.
Good luck with your project, I'd be interested to read it sometime :)
 
Don't forget that EMT-Intermediates also intubate!
 
Ridryder911 said:
Only in some states...
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Hmm...true, but in all the states which I practice in we do. I think it might be a majority of states which recognize Intermediates also allow them to Intubate. Off the top of my head I think Oaklahoma doesn't allow for it, but I don't have a comprehensive list.
 
Actually OK allows it (one of the first), but the NREMT/I does not officially endorse it. Only allows blind intubation such as Combitubes, King Airway, LMA etc. When there is intubation at NREMT testing sites, it is because the state has recognized it as an Advanced EMT procedure, not the NREMT.

Even AHA ACLS has removed intubation station and only requires training on LMA, Combitubes, and if licensed to perform intubation may do so, though not required. Advanced airway is now a sub-speciality class, AHA will be glad to offer you at a price.

R/r 911
 
In South Dakota I/85 are only trained with Combitube intubations, and, I believe, I/99 have all the advanced airways available to them short of the actual surgical procedures.
 
Last I heard, South Carolina was still allowing EMT-B to drop ET tubes.
 
disassociative said:
Last I heard, South Carolina was still allowing EMT-B to drop ET tubes.
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You wouldn't happen to know the total number of didactic hours for their basic class would you? Does that also have a clinical component then too? I would think it would have to.
 
EMS14 said:
You wouldn't happen to know the total number of didactic hours for their basic class would you? Does that also have a clinical component then too? I would think it would have to.
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Now you're getting on track. Training, education, how the skills were taught and mastered, skills maintenance, competency review, medical over sight and the lack of some or all of these I just mentioned is why it is an issue in some areas.

Here's a list of all of the states and their levels;
http://www.emsresponder.com/survey/SC.jsp

This is the 2005 list so the latest updates are not there but found easy enough on each state's website.
 
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Check the end of year issues of EMS Magazine; as they provide collected(though volunteered; not polled) data in regards to salaries, provider levels, training, etc by state and by locale. One such example would be Virginia's EMT-Shock Trauma which is much like EMT-IV's in Tennessee. Study the skills manual from the state websites as well as application requirements(specifically if they are NR states). As covered earlier, some states allow more skills than the national level prescribes; such as the case with EMT-IV in which the provider obtains NREMT-B; however the practical examination contains Intravenous Therapy stations, combitube/ptl, etc. I would also; and this is just my opinion--study the Canadian EMS system as a method of antithesis for your study as well as overall effect of longer--more in depth training in relation to your area of interest; in this case intubation. Do the numbers match up? Graph out your data--see if you notice a trend in regards to the correlation coeff of training vs application of skills. A good researcher builds a case for both views, backs them up with evidentiary support; the basis of which is supported by logic. This of course, is just my humble opinion, which unfortunately as of yet is not endorsed by a master's degree or any credential of which I could provide such suggestions.
 
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