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Thu Aug 9 08:16:46 BST 2007

Hi Ian,
Just gee m out is the correct option for H&S reasons. If you are having to
wear full PPE then you are in the wrong place to perform ALS interventions.
LMA may be a compromise but I would opt for BVM until in a cold zone.

Another option you may look at if your system opts for intubation in such
environments is AirTraq. 

Regards

Mike

Paramedic Mike Bjarkoy, Emergency Care Practitioner
Cornwall. England

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Ian Seppelt
Sent: 09 August 2007 06:55
To: roydanks at hotmail.com; Trauma &amp; Critical Care mailing list
Subject: RE: Casualty extrication from a fire risk area

I have intubated a manequin while dressed in full protective equipment
and breathing apparatus, in a simulated CBR incident. It is incredibly
difficult. In the real world 'Just get them out' is the correct option.
Ian

Ian Seppelt FANZCA FJFICM
Senior Staff Specialist
Dept of Intensive Care Medicine
The Nepean Hospital, PO Box 63 Penrith NSW 2751
Director of Clinical Research, Sydney West AHS
Clinical Lecturer, University of Sydney

>>> roydanks at hotmail.com 5/08/2007 1:57pm >>>
I would hesitate to call it a "mantra" (definition: a mystical formula
of invocation or incantation).
We have and continue to educate all levels of providers to remove the
patient/victim from the source of injury.  How many times have you been
in a truly hazardous environment with BA?  In a fire, it's hot, you're
breathing fast and your 30 or 60 min pack won't even be close to that
amount of time...not to mention, have you even thought about trying to
intubate someone while you're wearing full turnout gear, a 30 lb tank
and mask?

Now, instead, picture yourself in a "toxic" but non-fire
environment...say, purely CO.  Would you want to risk being in there,
fiddling with an airway, when your air runs out, or you can't secure the
airway but you decide to "just give it one more try"...and the clock is
ticking.

Since most of these situations aren't going to be at the depths of an
underground cave where prolonged extrication or transport is an issue,
the job is to: don your BA, get in, get the victim and get out.

In the words of the the Poltergeist...."Get out!"

RD

> Date: Sat, 4 Aug 2007 17:54:42 -0700> From: c_brault at yahoo.com> To:
trauma-list at trauma.org> Subject: Re: Casualty extrication from a fire
risk area> > All evidence points to :> > Just getting them out of their
is the best thing> > Charles> > > > > ----- Original Message ----> From:
"atacc.doc at btinternet.com" <atacc.doc at btinternet.com>> To: "Trauma &
Critical Care mailing list" <trauma-list at trauma.org>> Sent: Sunday,
August 5, 2007 2:08:21 AM> Subject: RE: Casualty extrication from a fire
risk area> > > We can answer much me this when you join us on ATACC,
cheers mark f, uk > > -original message-> Subject: Casualty extrication
from a fire risk area> From: <tuganddawn at talktalk.net>> Date: 04/08/2007
5:05 pm> > Dear all,> > I am a firefighter and paramedic working in
Oxford UK. I am currently researching the extrication of casualties from
smoke logged and fire risk buildings by Breathing Apparatus (BA) crews.
I am currently undertaking my BA training and am acutely aware of the
dificulties encountered when working in this type of environment but, as
a dual professional, feel that there must be a better way of dealing
with casualties. Current practice is still quite archaic and simply
follows the "just get them out" mantra.> Does anyone on the list know of
any programs or ideas that allow a BA crew to secure a basic airway,
administer clean air and manually handle the casualty in an ergonomic
and practical way without sacrificing the safety and efficacy of the
crew?> In any event, thanks for your time and trouble ladies and
gentlemen and I look forward to hearing your ideas.> > yours with
Kindest Regards> > Tristan "Tug" Crumpton> --> trauma-list : TRAUMA.ORG>
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Casualty extrication from a fire risk area