YIKES! Gut Tubed in Rhode Island x 12

KingCountyMedic

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mgr22

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I think this quote from the article makes it even more appalling:

But a coalition of Rhode Island’s EMS practitioners, municipal fire chiefs and a city mayor pushed back. They said the “ET tube,” as it’s known, saves lives. Taking it away, as one fire chief put it, “would be a sin.” A lobbyist for the firefighters union lambasted the doctors for not consulting more of its members before proposing such changes, saying, “We’re the experts ... not the doctors!”
 

Remi

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I think this quote from the article makes it even more appalling:

But a coalition of Rhode Island’s EMS practitioners, municipal fire chiefs and a city mayor pushed back. They said the “ET tube,” as it’s known, saves lives. Taking it away, as one fire chief put it, “would be a sin.” A lobbyist for the firefighters union lambasted the doctors for not consulting more of its members before proposing such changes, saying, “We’re the experts ... not the doctors!”
That’s one of the most obvious and public displays of the Dunning-Kruger effect that I’ve ever seen.
 
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medichopeful

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Does anybody have access to the full "We're the experts... not the doctors" quote? I'm curious about what all was said.
 

medichopeful

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I took that paragraph from the article linked by the OP. It's all there for you to read.
My apologies, I should have been more clear. I'm wondering what the "..." is standing in for.
 

Tigger

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I think this quote from the article makes it even more appalling:

But a coalition of Rhode Island’s EMS practitioners, municipal fire chiefs and a city mayor pushed back. They said the “ET tube,” as it’s known, saves lives. Taking it away, as one fire chief put it, “would be a sin.” A lobbyist for the firefighters union lambasted the doctors for not consulting more of its members before proposing such changes, saying, “We’re the experts ... not the doctors!”
The airway mismanagement is egregious.

The use of intermediatesque providers with minimal educational standards to provide the vast majority of ALS is even worse.

But the above takes the cake for most appalling.
 

VentMonkey

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So you've been to Providence, then?
I know a thing or two about a thing or two...

In all honesty? No, but I picked up what you were putting down.

Back on topic: deplorable, just deplorable. I real don’t know much about this system.
 

SandpitMedic

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To clarify- These are not Paramedics who were doing this. This is giving all of EMS and all Paramedics a bad rap and requires very clear public statements and illustrations. They are EMT-Cardiacs; a unique construct by Rhode Island fire departments.

It is basically a watered down and lowly trained version of a psuedo-Paramedic. From what I gathered, FF unions had a lot to do with it, so that their firefighters wouldn’t have to become paramedics to provide “ALS” services. They have lobbied to prevent the application of true ALS training, education, and certification.

And over on aisle 10 you can get some clown shoes.
 

Tigger

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To clarify- These are not Paramedics who were doing this. This is giving all of EMS and all Paramedics a bad rap and requires very clear public statements and illustrations. They are EMT-Cardiacs; a unique construct by Rhode Island fire departments.

It is basically a watered down and lowly trained version of a psuedo-Paramedic. From what I gathered, FF unions had a lot to do with it, so that their firefighters wouldn’t have to become paramedics to provide “ALS” services. They have lobbied to prevent the application of true ALS training, education, and certification.

And over on aisle 10 you can get some clown shoes.
But really, don't we think there are probably plenty of paramedics in systems with really, really crappy oversight as demonstrated here? The initial airway training that paramedics get is not required to be anything approaching thorough and while most programs require a few live tubes, is that enough to make a substantive difference if the providers are left to their own devices?

I see this as a systematic failure of an entire system, not as a provider level issue, though that certainly doesn't help.
 

SandpitMedic

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But really, don't we think there are probably plenty of paramedics in systems with really, really crappy oversight as demonstrated here? The initial airway training that paramedics get is not required to be anything approaching thorough and while most programs require a few live tubes, is that enough to make a substantive difference if the providers are left to their own devices?

I see this as a systematic failure of an entire system, not as a provider level issue, though that certainly doesn't help.
Then you are using adverse outcomes which occurred in a specific jurisdiction under very unique and well defined circumstances as a straw mans argument for an issue that you perceive to be a bigger issue than it actually is.

Most paramedics are not goosing the tubes, and with the widespread knowledge and use of ETCO2 as the gold standard, we are course correcting to almost no medics leaving a tube in the wrong hole.

Should there be more training, yes, absolutely, we agree. Perhaps if education were extended to allow more airway training in something like paramedic degree programs.
 

Aprz

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I think the people who post here are likely better and more humble than most EMTs and paramedics. I wouldn't be surprised if this is a nation wide problem that has gone unrecognized or ignored.
 

E tank

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I see this as a systematic failure of an entire system, not as a provider level issue, though that certainly doesn't help.
Agree with this...EMS is the most bizarre set up in all of health care in the US. It is the only provision of what can be advanced medical care that is partly ignored by the physicians that have responsibility for it.

From firemen interfering with care on scene to stuff like this, those responsible for the direction and success of their delegated care blissfully and willfully remain ignorant until the patient rolls through the doors of the hospital as if the care he has received, good or bad, doesn't matter and just gets considered along with all of the other presenting factors.

Broad generalization, yeah, but it is a major element in pre-hospital care in this country.
 

KingCountyMedic

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Looking into the FB page of one of their EMT cardiac folks (wannabe medics) their level of incompetence is nothing compared to their level of arrogance. 12 patients are dead, transported with GUT tubes and they just don’t get it! One guy said “Doctors miss tubes too”
I’m baffled that this goes on in 2019 American EMS.
 
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