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Home > List Archives

Difficult intubation of pt in vehicle-

Gavin TURNER trauma-list@trauma.org
Fri, 17 May 2002 15:13:05 +0100


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Dear Steve,
I assume that you enquiry regarding adjuncts to aid difficult intubation =
follows the theme of the RTC / MVC. The aids available are many and =
include:
i- A larger laryngoscope blade (4 instead of 3)
ii- A McCoy Blade which has the ability (in Theory) to convert a Grade 3 =
larynx into a Grade 2 etc
iii- A polio blade used for pts with limited neck extension as in those =
appropriately immobilised
iv- Gum elastic bougie to railroad ETTube over after correct insertion =
of bougie
v- The Intubating LMA insert ILMA then intubate through it then remove =
ILMA and hey presto intubated!!!!

There I think are enough to be going on with in the Pre-Hospital Arena, =
but however the more elaborate the effort to intubate the more time the =
patient is kept on scene and remember  "THE GOLDEN HOUR BELONGS TO THE =
PATIENT "  Keep it simple BVM and OPAirway and secure a definitive =
airway if necessary whilst en-route.

Best Wishes
Gavin Turner
Trainee ODP
 "You must have your own fun. No one can have it for you"
  ----- Original Message -----=20
  From: Steve Bixby=20
  To: trauma-list@trauma.org=20
  Sent: Thursday, May 16, 2002 6:43 PM
  Subject: Re: intubation of pt in vehicle


  Is anyone aware of any devices or accessories that can be used to =
assist with difficult intubations?  If not, is there a need for such a =
product?

  Thanks-
  Steve =20
    ----- Original Message -----=20
    From: BALLMEDIC@aol.com=20
    To: trauma-list@trauma.org=20
    Sent: Thursday, May 16, 2002 9:01 AM
    Subject: intubation of pt in vehicle


    Otaining a patent secured airway in a trauma pt whether inside a =
vehicle or outside of a vehicle is paramount.  I have intubated pt's =
inside of vehicles with severly compramised airways. It does however =
take  education and practical training in some of the techniques.  The =
airway  has to be maintained by whatever means that is required, ie =
positioning or intubation ect.  Should our entrapped pt's not recieve =
proper airway management just because the procedure is more difficult? =
Airway  management is crucial wherever the pt is.=20

    DONNIE MARTIN NREMTP=20
     N.C=20

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<BODY bgColor=3D#ffffff>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>Dear =
Steve,</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>I assume that you enquiry =
regarding=20
adjuncts to aid difficult intubation follows the theme of the RTC / MVC. =
The=20
aids available are many and include:</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>i- A larger laryngoscope =
blade (4=20
instead of 3)</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>ii- A McCoy Blade which has =
the ability=20
(in Theory) to convert a Grade 3 larynx into a Grade 2 =
etc</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>iii- A polio blade used for =
pts with=20
limited neck extension as in those appropriately =
immobilised</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>iv- Gum elastic bougie to =
railroad=20
ETTube over after correct insertion of bougie</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>v- The Intubating LMA =
insert ILMA then=20
intubate through it then remove ILMA and hey presto=20
intubated!!!!</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2></FONT></EM>&nbsp;</DIV>
<DIV><FONT face=3D"Kristen ITC" size=3D2><EM>There I think&nbsp;are =
enough to be=20
going on with in the Pre-Hospital Arena, but however the more elaborate =
the=20
effort to intubate the more time the patient is kept on scene and =
remember&nbsp;=20
"<STRONG>THE GOLDEN HOUR BELONGS TO THE PATIENT&nbsp;"&nbsp; =
</STRONG>Keep it=20
simple BVM and OPAirway and secure a definitive airway if necessary =
whilst=20
en-route.</EM></FONT></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2></FONT></EM>&nbsp;</DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>Best =
Wishes</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>Gavin =
Turner</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>Trainee =
ODP</FONT></EM></DIV>
<DIV><EM><FONT face=3D"Kristen ITC" size=3D2>&nbsp;</FONT></EM>"You must =
have your=20
own fun. No one can have it for you"</DIV>
<BLOCKQUOTE dir=3Dltr=20
style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
  <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
  <DIV=20
  style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
  <A title=3Dsbixby@montana.com href=3D"mailto:sbixby@montana.com">Steve =
Bixby</A>=20
  </DIV>
  <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
  href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Thursday, May 16, 2002 =
6:43=20
PM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> Re: intubation of pt =
in=20
  vehicle</DIV>
  <DIV><BR></DIV>
  <DIV><FONT face=3DArial size=3D2>Is anyone aware&nbsp;of any devices =
or=20
  accessories that can be used to assist with difficult =
intubations?&nbsp; If=20
  not, is there a need for&nbsp;such a =
product?<BR><BR>Thanks-</FONT></DIV>
  <DIV><FONT face=3DArial size=3D2>Steve&nbsp;&nbsp;</FONT></DIV>
  <BLOCKQUOTE=20
  style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
    <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
    <DIV=20
    style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
    <A title=3DBALLMEDIC@aol.com=20
    href=3D"mailto:BALLMEDIC@aol.com">BALLMEDIC@aol.com</A> </DIV>
    <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
    href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
    <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Thursday, May 16, 2002 =
9:01=20
    AM</DIV>
    <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> intubation of pt in=20
    vehicle</DIV>
    <DIV><BR></DIV><FONT face=3Darial,helvetica><FONT size=3D2>Otaining =
a patent=20
    secured airway in a trauma pt whether inside a vehicle or outside of =
a=20
    vehicle is paramount. &nbsp;I have intubated pt's inside of vehicles =
with=20
    severly compramised airways. It does however take &nbsp;education =
and=20
    practical training in some of the techniques. &nbsp;The airway =
&nbsp;has to=20
    be maintained by whatever means that is required, ie positioning or=20
    intubation ect. &nbsp;Should our entrapped pt's not recieve proper =
airway=20
    management just because the procedure is more difficult? Airway=20
    &nbsp;management is crucial wherever the pt is. <BR><BR>DONNIE =
MARTIN NREMTP=20
    <BR>&nbsp;N.C</FONT> </FONT></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML>

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