List Archives

Wed Apr 19 03:13:04 BST 2006

Up to what expense should anybody try more than 3 times?

I've sure had my third attempts, even a fourth and a fifth until the tube
finally went in. But I guess I was just lucky because if, because of
overconfidence, I would've kept trying and turned out not to be successful,
I would've ended with an edematized trachea that is giving a hard time to
intubate and ventilate... therefore setting the stage for a scenario of
"human excreted byproducts impacting the air distribution system".

Gustavo E. Flores Bauer, BS EMT-P :.
EmergencyTeam.Net
San Juan, Puerto Rico
MSII, Iberoamerican University
Santo Domingo, Dominican Republic

809-309-9779
MSN Messenger: gustavoflores911
E-Mail: gustavo at emergencyteam.net
Web: www.emergencyteam.net
-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of HAXScott at aol.com
Sent: Tuesday, April 18, 2006 9:56 PM
To: trauma-list at trauma.org
Subject: Re: AW: just BLS them....

ASA algorithm supports a limit of 3 attempts... 

>From Mort, TC - Emergency Tracheal Intubation: Complications Associated
with 
Repeated Laryngoscopic Attempts. Anesth. Analg 2004, 99:6-7-613 
In a review of offsite intubations in a major urban Level 1 trauma center,  
relative risk serious complications of  >2 attempts:
Severe hypoxemia - 14X
Aspiration - 4X
Bradycardia - 4X
Cardiac arrest - 7X (!!!) 

Dr. Mort's exceptional works should be must-reads for anyone with any  
responsibility for a patient's airway.

Scott Hax
Lebanon, NH 

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AW: just BLS them....