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LMA

jkaymdc at aim.com jkaymdc at aim.com
Thu Apr 6 23:06:07 BST 2006


Yes, I agree that breath sounds are not enough, and not recognizing or 
admitting it isn't where it should be is something that needs to be 
reinforced and fixed and not become a penal issue to "nail someone" on, 
something I have heard CQI people say when they find an "error".

  However, having said that, we do a disservice to the basic level 
providers when we don't teach them lung sounds appropriately. Not just, 
are they there or not, but what do they sound like and here's a 
clue...is the chest rising or God forbid, is the "stomach" rising.

  We can all benefit, especially the patient from using excellent 
"basic" skills and understanding what our patient is telling us, 
verbally and physically. And, wishful thinking, but cost for things 
like End tidal C02 detect, etc..should not take precedence over what is 
in the best interests of the patients, as most of us all believe...

 Jules

 Julie K. Scadden, NREMT-P, PS
 Iowa

 -----Original Message-----
 From: HAXScott at aol.com
 To: trauma-list at trauma.org
 Sent: Thu, 6 Apr 2006 17:11:15 EDT
 Subject: Re: LMA

  Combitube in the trachea isn't really a huge problem - if someone 
scores it
  in the trachea, changing it over to an ETT will be very simple with a 
tube
  changer or a long bougie... Not recognizing it will have fatal 
consequence.

  I'm with you on the toys... would you agree lung sounds are not 
enough?? I
  think you NEED to use a secondary confirmation device when you use a 
Combitube.
 I think breath sounds alone = danger.
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