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Thu, 04 Apr 2002 10:52:08 +1000

I agree with you. Our paramedics have only recently started carrying Midazolam
for status epilepticus. They've got no chance tubing a difficult patient without
drugs which they are not allowed to carry. Would it not be better off for the
patient to be paralysed & have a less invasive procedure done?
Sheree

"James A. Johnson" wrote:

> I had a trauma pt with a closed head injury secondary to snowmachine
> accident. pt was unconscious/unresponsive, no other trauma noted pt resp.
> rate 32-34 irreg. pt jaw clamped. unable to call life flight due to weather.
> ground transport time code red 20-25 min. to a non trauma E.D. 5 mins. into
> transport pt began to show signs of posturing and started vomiting, pt had
> to be rolled and suctioned but was unable to clear airway effectively. Pt
> then started to brady down to the 30 despite bvm assist. in our service as
> an  EMTIII we are able to provide many advanced skills and we have
> progressive standing orders, however it's been a fight to get the sponsoring
> physician to allow paralytics in the field. stating he feels it may be
> misused in the out lying areas who have lower run volumes and weaker skills.
> My thoughts are if they lack the skills don't let them use it, other
> thoughts from the paramedics I have spoken to feel a cric is preferred. I
> would rather use a short acting drug to allow me to tube than cut someone's
> throat, because I feel if the attempt is missed I can go back to the BVM,
> and oral airway. comments please.
>
> Jim Johnson EMT III
>
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paralytics vs. surgical cricothorotomy in the field