MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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Great post! Appreciate your honesty. What I have found with ETI and it's inherent difficulties, is knowing when to quit and move on. Adult "no-neckers", peds that were difficult to tube, multitrauma lying on the road after being ejected from their car with maxillofacial injuries and were gurgling. They required a nasotrachial intubation without manipulating the C-spine. Difficult? Yes. Impossible? No. Put their head in your crotch, legs over their shoulders, and GENTLY pass the tube through a nare while SLOWLY visualizing the airway (#3 Miller usually). So tired of some of these posts that quote studies so they can give up.We applaud doing away with a skill that is very low frequency and high risk because as a whole we suck at it and since we suck at it we found out we were killing patients. CA pulled information on all the pediatric patients in the state who were tubed or at least it was attempted and compared it to patients who were not and found the latter had better survival rates.
Yes there will always be that one patient who may die because we are unable to tube but it will save the other 9 kids from dying at our hands because we took too long to get the tube, spent too much time on scene, cause too much airway trauma, didn’t realize improper tube placement, or failed to reassess tube placement.
If the intial education, clinical rotations, continued skills verifications, mandatory ongoing training was better then we maybe able to keep these skills but once again as a whole we don’t have that.
I am all for increased survival rates over skills.