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PHTLS, Ground EMS, Air EMS, Chest Tubes

jkaymdc at aim.com jkaymdc at aim.com
Mon Apr 10 02:26:49 BST 2006

-----Original Message-----
From: Michael Ferker <xg2k2 at yahoo.com>
To: Trauma &amp, Critical Care mailing list <trauma-list at trauma.org>
Sent: Sun, 9 Apr 2006 18:06:18 -0700 (PDT)
Subject: Re: PHTLS, Ground EMS, Air EMS, Chest Tubes

>>>>Certainly, if an EMS doesn't have sufficient training and 
experience in
>>>intubation, they should stay away from the pt.

Stay away from the patient is very extreme. Can we all please remember 
there are alternative to intubation that do work whenperform 
appropriately? BVM with oropharyngeal airways has been know to provide 
an adequate airway, as has a combitube, LMA and others...but let's not 
repeat that discussion here. The point is, you should not stay away, 
you should do what you have been trained to do and that you can *do 
competently*, including the basics, which are still what saves lives.

>>>>> But if the proper training was
provided and there is a serious condition such a p or h thorax that can 
be aided
with some simple pressure relief, I don't see a reason why such a step 
be taken.

      Perhaps, but let's again remember that there is a huge cavern 
between training and maintaining proficiency in a skill.

  -Mike F

It is difficult to make definitive decisions on what can/should be 
*allowed* in prehospital treatment skill. There are areas of the 
country where you may very well need these skills and utilize them 
enough to be proficient in them. There are probably more providers who 
are taught some of these skills in a PHTLS class for example, but have 
never performed or even needed to perform one in their careers.  There 
are vast differences throughout this country and others between what is 
in the best interest of the patient as regards to prehospital care. One 
thing that I have seen to be consistent everywhere is the basics of 
*Airway, Breathing and Circulation*.


Julie K. Scadden, NREMT-P, PS

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