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Tue Apr 11 15:40:29 BST 2006

Great points. I'm confused about several of the facts as stated also. For
one thing I'm acquainted with Frank and have always considered him a strong
EMS advocate. Not only do I have doubts about the Urgent Care doc being set
up to intubate, he certainly couldn't "give orders" to the medics as he is
not part of their medical control.

Rob Smith, MD 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Jeffrey Leach
Sent: Tuesday, April 11, 2006 8:05 AM
To: trauma-list at trauma.org
Subject: In regards to EMS intubation issues

According to the JEMS article, Etomidate is described as a paralytic, when
in fact it is an induction agent. While etomidate would be appropriate to
administer in this case, it may or may not relax the Pt. enough to
accomplish intubation. A true paralytic would have solved the problem of a "
clinched jaw ". If the Paramedics in this case did not have a paralytic per
protocol, one must wonder if the Urgent Care Facility Physician could have
facilitated intubation with a paralytic drug. In regards to the
documentation issue, we should all remember that if it is not documented,
then it was not done...

                  Jeffrey P. Leach, EMT-P
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In regards to EMS intubation issues