Airway, Breathing or Consequences: Use Your Tools and Trust the Technology

“An esophageal intubation is no sin, but there is great sin in not recognizing such a placement.” — Special Operations Combat Medical Skills Sustainment Course (U.S. Special Operations Command) How hard is it take to properly intubate the trachea? Actually, it’s far more difficult than most people think. Recent anesthesia research shows that at least 75 live adult intubations are needed to achieve a 90% initial competency.1 Yes, 75! Not the very limited live number that are experienced in many paramedic schools, and certainly not only practicing with manikins. And how hard is it to intubate the esophagus? Unfortunately, way too easy. So, when faced with the need to secure an airway in emergency situations, how likely is it that the tube will end in the proper place? If you’re a pessimist at heart (or possibly a realist), the odds seem pretty good for a misplaced tube. That’s not a good thing. After all, having a patent airway is critical to breathing—and life in general. How do we increase the odds in our favor? Well, certainly practice, practice, practice would be a key. The other thing we need to do is use the tools at our disposal to verify proper tube placement, and we must trust the findings that those tools provide. And this applies not occasionally, not most of the time, but rather, we need to use the tools and trust the results with every tube, every time, and with every major move. How do we verify tube placements? What evidence are we looking for, and ...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news