Surgical Airways

[emtjack02]

Needle and surgical allowed in Illinois. I have not been practicing very long so luckily non in the field. Saw needle and surgical in the hospital. Like most other places, only needle for children.

 

[Fox800]

Surgical and needle here.

Surgical for pt.'s over 40kg/10 years old.
Needle for under 40kg/age 10 or under.

Haven't seen one done yet. It would be a hot topic.

 

[Onceamedic]

We've been allowed to do surgical airways in Arizona. About 5-6 months ago, we got the Quicktrachs. Done some in-service training sessions with them and they were included in the last airway lab. They would be my first choice if a trach is required.

 

[emtfarva]

Needle only. Our medical director will not let medics do it here. Only CCRNs can perform surgical.

 

[82-Alpha599]

Thats a positive for South East Michigan except for Macomb county.

how effective is a needle cric anyways?

 

[Akulahawk]

Unless something has changed in the last couple years, California doesn't allow Paramedics to do a Surgical Cric. Needle Cric only...

 

[atropine]

I wouldn't mind them taking away our surgical protocol, no one and I mean no one has ever done one to my knowledge.

 

[JPINFV]

LA County doesn't have, and never did in the recent history (i.e. last 5 years) have, a surgical cric protocol. They used to be able to do needle crics, but according to this scope of practice document dated 7/1/09, they can't even do those anymore.

I'm more than willing to read anything official you might have that shows that LA County EMS used to allow surgical crics.

 

[atropine]

I got nothing, buts that cool one less thing to worry about.

 

[Smash]

I got nothing, buts that cool one less thing to worry about.

I'm sure we all sleep easier knowing that.

 

[Griff]

In southern Alabama we can't do surgical airways. We can't even do needle crichs, although that might be a service specific restriction.

 

[Bluestar]

Were allowed to do them at my home service here.....although we have gotten away from it and went to needle crics. It is still in our protocols and we are still inserviced on both though.

 

[ah2388]

At the service im riding with, I believe they can do surgical, needle, and quick trach's. As far as I know they dont carry the needle kits anymore.

 

[Dominion]

We cannot do surgical as it's not in our protocols. However my service has standing orders for needle cric

 

[Fox800]

For those of you that aren't allowed any sort of surgical airway...what are you supposed to do with a patient in a cannot ventilate/cannot intubate situation? Just let them deoxygenate and arrest? Mainly your anaphylaxis patients and severe maxillofacial trauma situations.

 

[alright35]

Maryland and Pennsylvania allow surgical airways.

interesting you say Pa. allows surgical airways, because we just had our class for crichoidotomy, and our teacher said even though we learn surgical, that Pa. does not allow it in our scope. I have not looked at my protocols yet, but i assume my teacher, (also a flight medic in Pa.) would know. anyway, he also stressed that he has never had to to a needle or surgical crich ever, so i am assuming that it is not done too often.....of course i am sure there are some who do it quite often

 

[redcrossemt]

interesting you say Pa. allows surgical airways, because we just had our class for crichoidotomy, and our teacher said even though we learn surgical, that Pa. does not allow it in our scope. I have not looked at my protocols yet, but i assume my teacher, (also a flight medic in Pa.) would know. anyway, he also stressed that he has never had to to a needle or surgical crich ever, so i am assuming that it is not done too often.....of course i am sure there are some who do it quite often

The Pennsylvania Statewide ALS protocols do allow for needle or surgical crichothyrotomy. It's unclear to me if it requires medical control or not. Also, I'm not sure about Pennsylvania but here in Michigan local medical control authorities can limit your standing orders so it might not be available in your local area.

For the Pennsylvania state protocol, see 3001 at http://www.dsf.health.state.pa.us/h...a_protocols_-_master_-_effective_11-01-08.pdf.

 

[Akulahawk]

For those of you that aren't allowed any sort of surgical airway...what are you supposed to do with a patient in a cannot ventilate/cannot intubate situation? Just let them deoxygenate and arrest? Mainly your anaphylaxis patients and severe maxillofacial trauma situations.

If your system allows a needle cricothyroidotomy, do that... and run to the ED as quick as the proverbial bat out of hades... within the limits of safety... otherwise... apply much diesel, and keep attempting to ventilate in any way you can. The patient would likely have a really bad day in that situation.

 

[MissMedicCMO]

Vigo Co & Clay Co, Indiana does..... No ive never done one but im fairly new to my medic title.

 

[Melbourne MICA]

Surgical

Ambulance Victoria (Australia) allows them in our failed intubation drill - no Paeds needle cric and MICA only. Never done one. Only know of two or three having been done service wide.

MM