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Difficult airway

Eitan Melamed trauma-list@trauma.org
Sat, 23 Nov 2002 03:15:15 -0800 (PST) 

The scene was 45 minutes from a trauma center(and from
any other hospital), indeed with poor conditions for
intubation. The available drug was ketamine.
--- "Bjorn, Pret" <pbjorn@emh.org> wrote:
> I think this depends on where (and under what
> conditions) this initial
> intubation attempt is being made.  If you're
> monkeying with a partially
> obstructed airway at the scene, then I agree that
> you're making a mistake.  
> 
> If, on the other hand, this patient is being treated
> at a local community
> hospital in preparation for an hour's drive to the
> trauma center, I think
> there's a very strong argument for intubating in
> good light on a level
> surface with ample equipment, supplies, drugs and
> personnel.  It's immensely
> easier to intubate a partial obstruction in a small
> ED than a complete
> obstruction in the back of a large truck.
> 
> Not clear which scenario is in play here.
> 
> Pret Bjorn
> Trauma Coordinator
> EMMC Trauma Program
> 489 State Street
> Bangor, ME 04401
>  
> 207.973.7260 (office)
> 207.973.7673 (fax)
> 207.941.5085 (voice pager)
> 
> 
> -----Original Message-----
> From: P. Hoffman [mailto:phoffman@freeway.net]
> Sent: Friday, November 22, 2002 10:47 AM
> To: trauma-list@trauma.org
> Subject: RE: Difficult airway
> 
> 
> I, too, am curious...  Why the intubation?  Is there
> more to the story than
> you reported?
> 
> Phil Hoffman
> EMTP
> 
> -----Original Message-----
> From: trauma-list-admin@trauma.org
> [mailto:trauma-list-admin@trauma.org]On Behalf Of
> Eitan Melamed
> Sent: Friday, November 22, 2002 9:28 AM
> To: trauma-list@trauma.org
> Subject: Difficult airway
> 
> 
> 
> 
>  Here's a case from a of week back.
> 
> A 20 year old gets a penetrating missile neck wound,
> develops swelling in his neck. He talks with a
> whispering voice, Sat%-98, GCS 15 at scene. Before
> taking him to a trauma center, which is 45 minutes
> away, intubation is attempted. 2 attempts fail.
> What next?
> 
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