WWYD: Butane inhalation & ignition

HardKnocks said:
Question;

I understand the mechanics of the possibility of upper//lower airway burn and compromise;

If a BLS Crew, was on first scene, (and ALS was extended ETA), would an IGEL (for an unconscious Pt) be an interim Vent option, until ALS or ER can tube em? (Note: I-Gels are in the Scope of Practice for EMT-B here in AZ).

I've read that a large bore I-gel can be used as a conduit for later intubation, in some circumstances.

Btw, what was the Kids Tidal Volume and 02 Sat?
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If anyone meets criteria for a supraglottic airway, put it in.
 
Agreed,

As a BLS Crew I'd use the I-Gel then, I'd bag em, (with the distressed RR of >28).

I was just trying to stir more conversation on Tubing the Pt in conjunction with an I-Gel.

The hurdle I have is that no paralytics can be used. ;(
 
HardKnocks said:
Agreed,

As a BLS Crew I'd use the I-Gel then, I'd bag em, (with the distressed RR of >28).

I was just trying to stir more conversation on Tubing the Pt in conjunction with an I-Gel.

The hurdle I have is that no paralytics can be used. ;(
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In a situation where an ALS person showed up with a more or less functioning SGA, leaving it where it is would be the wisest course as opposed to attempting a definitive airway with an ETT. This is especially true in this scenario. Adding mucosal tissue trauma to a fried airway by blindly shoving a tube through a working igel is asking for trouble. Trying with a non working SGA would be criminal. That said, once in the hospital where reliable surgical airway access is more of a possibility, different story. Looking down the SGA with a flexible bronchoscope to see what's what and then passing a tube over the scope is good in a pinch.
 
E tank said:
In a situation where an ALS person showed up with a more or less functioning SGA, leaving it where it is would be the wisest course as opposed to attempting a definitive airway with an ETT. This is especially true in this scenario. Adding mucosal tissue trauma to a fried airway by blindly shoving a tube through a working igel is asking for trouble. Trying with a non working SGA would be criminal. That said, once in the hospital where reliable surgical airway access is more of a possibility, different story. Looking down the SGA with a flexible bronchoscope to see what's what and then passing a tube over the scope is good in a pinch.
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This is where the King has its advantage - the ability to pass the ETT through it by design if I recall correctly.
 
proctorologist said:
Sure - you'd never want to try something that's a feature built into the device...unless of course you can somehow find a way to use duct tape and a garden hose to fix the problem...
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Consider what a KT does and how it works. Then perhaps you might rethink your assertion here.
 
Akulahawk said:
Consider what a KT does and how it works. Then perhaps you might rethink your assertion here.
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But confident wrong is so entertaining sometimes.

Then again, he may be using some Home Depot accessories on the KT.
 
proctorologist said:
This is where the King has its advantage - the ability to pass the ETT through it by design if I recall correctly.
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So please, let us know the last time you actually inserted a King tube?

How about inserted a King tube in a Burn patient?

How about the last time you've inserted a King tube in ANY patient?

So, you took an ACLS course, and now you think you're an Emergency Medicine expert?

How old are you?
 
Rubicon Bob said:
So please, let us know the last time you actually inserted a King tube?

How about inserted a King tube in a Burn patient?

How about the last time you've inserted a King tube in ANY patient?

So, you took an ACLS course, and now you think you're an Emergency Medicine expert?

How old are you?
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Definitely giving off the all academic no patient experience vibes.
 
ffemt8978 said:
Definitely giving off the all academic no patient experience vibes.
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Agreed

But I'd also like to know how much "academic" they actually have, and how old are they?

My W.A.G. (Wild *** Guess) would be this person is in their mid to late 20's, and just graduated, thus they know it all.
 
Rubicon Bob said:
Agreed

But I'd also like to know how much "academic" they actually have, and how old are they?

My W.A.G. (Wild *** Guess) would be this person is in their mid to late 20's, and just graduated, thus they know it all.
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That's up to them if they want to share such info, just like anyone else here. Just an observation though, claimed age and credentials don't equate to credibility around here...critical thinking does.
 
FWIW I had to look it up because the king airway is so out of date now that I couldn’t remember..

King isn’t designed to intubate through..
 
proctorologist said:
This is where the King has its advantage - the ability to pass the ETT through it by design if I recall correctly.
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You might be confusing the ETT tube with a Gastric Tube, which the king does have an access lumen designed for gtube placement; if the gtube is preloaded before you place it in the patient. Side note: they go in to different places, and serve completely different purposes, so you might need to brush up on your recollection of SGA devices...
FiremanMike said:
FWIW I had to look it up because the king airway is so out of date now that I couldn’t remember..

King isn’t designed to intubate through..
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serious question: since when is the king out of date? I know combitubes and LMAs aren't very common prehospitally (although I think LMAs are very common in ORs), but both King and iGel were the primary SGA in my region.
 
DrParasite said:
You might be confusing the ETT tube with a Gastric Tube, which the king does have an access lumen designed for gtube placement; if the gtube is preloaded before you place it in the patient. Side note: they go in to different places, and serve completely different purposes, so you might need to brush up on your recollection of SGA devices...

serious question: since when is the king out of date? I know combitubes and LMAs aren't very common prehospitally (although I think LMAs are very common in ORs), but both King and iGel were the primary SGA in my region.
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Data showed frequent over inflation of the large balloon which was causing airway damage and carotid circulation issues. i-gel was coming out at the same time which didn't have those issues.

King airway faded away
 
DrParasite said:
You might be confusing the ETT tube with a Gastric Tube, which the king does have an access lumen designed for gtube placement; if the gtube is preloaded before you place it in the patient. Side note: they go in to different places, and serve completely different purposes, so you might need to brush up on your recollection of SGA devices...

serious question: since when is the king out of date? I know combitubes and LMAs aren't very common prehospitally (although I think LMAs are very common in ORs), but both King and iGel were the primary SGA in my region.
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You don’t have to preload the king with a gastric tube. You can place the OG after the King is inserted.

The King also advertises that you can place a bougie down the main BVM port and it should be directed towards the glottic opening at which time you could essentially do a tube exchange via bougie.

The Kings have fallen out of favor in the past couple of years due to overpressure in the balloon causing restricted carotid arteries and jugular vein drainage. There are several other popular options out now with the iGel being one of the main ones, that also has its own issues.
 
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