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Wed, 10 Apr 2002 16:50:00 +1000

............ but I did find strength in a quote by Dr. D. John Doyle: "A
surgical airway is better than an arrested patient with a nice-looking
neck."................

Dr Doyle's quote does nothing to imply that a surgical airway should be done
in preference to a tubed airway.

Holmes' corollary:  " A trachea with a tube in it is better than a neck with
a knife in it".

John

Dr  J Holmes
 ----------
From: Jeff Brosius
To: trauma-list@trauma.org
Subject: Re: paralytics vs. surgical cricothorotomy in the field
Date: Tuesday, 9 April 2002 20:47

> This statement proves my point. QED.  EMS-Ts are not adequately qualified
in
> this field.  To state that an invasive surgical procedure is preferable to
> RSI is judgementally extremely flawed and very very scary.  I challenge
you
> to find one airways trained physician to agree with you.
>

Understand that I'm not trying to start a war....

EMS Providers are trained, guided, certified/licensed, and authorized to
practice under the auspices of a physician.  IF you don't think that we
EMS'ers are capable enough or educated enough, then YOU should teach us.
This reminds me of the conversation I once had over lunch with one of the
EMS Medical Directors in Georgia when we were discussing extending the scope
of practice to meet the national standards:

ME: "So what keeps you from including such ideas into the scope of practice
for medics?"
HIM: "I don't think medics are capable of that sort of thing....you're not
educated or qualified to do it."
ME (pointing to my 'Georgia Composite Board of Medical Examiners'
certification patch'): "See this patch?  YOU gave it to me.  If YOU don't
feel I'm capable of performing my job, then WHY did YOU give me the patch?"
(Things got kinda tense at that point....)

As for the second, I don't recommend a surgical airway as a routine
procedure, but I did find strength in a quote by Dr. D. John Doyle: "A
surgical airway is better than an arrested patient with a nice-looking
neck."  ( http://anzics.herston.uq.edu.au/esia/ESIA9610/AIRWAY.htm )

I'm probably wrong, but oh well...

Best,

Jeff Brosius
Paramedic, etc.
Atlanta, GA
www.prehospital-perspective.com
medic245@mindspring.com
"The fate of the wounded rest
in the hands of the one that
applies the first dressing."
 -- Nicholas Senn, 1896

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paralytics vs. surgical cricothorotomy in the field