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Tue Mar 6 04:07:34 GMT 2007

Nasal tube would be for someone that had a clenched jaw.  We do not carry
any type of paralyzing agent on the rig.

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Andrew J Bowman
Sent: Monday, March 05, 2007 10:46 PM
To: Trauma &amp, Critical Care mailing list
Subject: Re: Thanks Karim

I also avoid NT. Orotracheal intubation can be accomplished in trauma with
manual in-line stabilization and with the anterior part of the c-collar
removed during the intubation. If glottic visualization is still difficult
use a bougie catheter.

Andrew

On 3/5/07, Errington Thompson <errington at erringtonthompson.com> wrote:
>
> 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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Thanks Karim