Thanks Karim

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Nasal intubations should be avoided.  If you are able to bag the patient I
would rather have a patient that is bagged than a tube in the nose.  

I would add I hating Combitubes.  

Errington C. Thompson, MD, FACS, FCCM
Trauma/Surgical Critical Care
Mission Hospital
Asheville, NC
Author - A Letter to America
www.whereistheoutrage.net

 
Everyone deserves to make an informed decision
                                - Errington Thompson, MD


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Anthony Caruso
Sent: Monday, March 05, 2007 9:12 PM
To: trauma-list at trauma.org
Subject: Thanks Karim

Evening all. I would like to ask the group there opinion on how they feel
about nasal intubations pre-hospital in the trauma setting?  In my region,
in Massachusetts we are about 22 min away from a level 1 trauma center at
almost any given time.  On board, we do carry Hurricane spray along with
affrin to vasoconstrict the nares.  Usually a 6.0 ID or a 6.5 would do the
job with a little more air in the cuff than normally used.  (About 12m/L of
air) and liberal use of lidocane jelly.      
    I'm particularly interested in closed or open head trauma.  However if
you have any type input on this subject then I would certainly welcome it.
Also Dr. Gross, I believe that you flew, or still work on a medical rescue
helicopter.  What was your experience when you encountered someone that was
nasotracheal intubated?
     Sincearly,
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