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Home > List Archives

Muscle relaxant in the filed and helicopters

Ashton Treadway napthene at gmail.com
Thu Apr 20 18:08:33 BST 2006


Howdy:

At least from what I've been taught, RSI is contraindicated if you do
not believe that you have the means (due to lack of skill, lack of
confidence, or structural concerns) to maintain the airway if tube
placement fails.

We're taught that the foundation of the decision to use RSI is a high
index of confidence that you can fully control the airway after the
patient is paralyzed.

If a paramedic didn't possess that high index of confidence and
proceeded with RSI anyway, I, for one, would have questions as to why
they did so. If the outcome of RSI is "cutting a hole in the neck",
I'm /willing/ to consider that something unexpected occurred, but it
seems equally possible that someone either made a questionable
decision to go with RSI in the first place, or botched the tube
placement.

My $0.02.

Ashton

On 4/19/06, Lamb, Keith D. <KLamb at christianacare.org> wrote:

[trimmed]

> I "think" that one of the biggest concerns about the use of muscle relaxants
> pre-hospital is what do they do if they cant facilitate an appropriate
> airway after the patient is relaxed. What if they cant maintain a patent
> airway and BVM the patient after the relaxant. Then they (pre-hospital
> personnel) would have to do the same thing that we would do in-hospital, and
> put a hole in the patients neck.


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