NomadicMedic
I know a guy who knows a guy.
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The money would be okay. I do enough side work and consulting that I can make it happen. Plus, my wife is super vet.
she's my sugar mama. Hahaha
the 100% directionless thread
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The money would be okay. I do enough side work and consulting that I can make it happen. Plus, my wife is super vet.
she's my sugar mama. HahahaTricky airway?
Yeah, but anymore I open it on every intubation. If I dont get the view I want right away I use it. Sometimes even if I have a clear view Ill still use it depending on the EMT or fire personnel I have so they get the experience.
I know my first time success rate has skyrocketed since I began using it routinely.
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It's one of those things that surprised me some people view as a crutch. They are actually a requirement for every intubation we do.
My partner gives me hell at the mention of a bougie. Doesnt bother me, I secure airways faster with a greater first pass success.
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NomadicMedic
I know a guy who knows a guy.
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Bougie. Every tube, every time.
You may not need it, but you've got some practice in.
You may not need it, but you've got some practice in.
Why? Same general idea as a stylet, except it doesn't bend weirdly if you bump it....
Cause hes "been doing this for 17 years without a bougie"
Just a closed minded dinosaur that thinks he is gods gift to EMS.
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Ah, great reasoning. That's probably the hardest part about coming into this field and learning the way I did, partially due to all of y'all. There is a lot of **** I don't know, and I am no expert on pretty much anything, but I know enough to realize there is plenty of stuff I see done that I think is dumb or dangerous. Many times I have been given the standard response like you got.
While we are on the topic of intubation, anyone have any tips on intubating while cpr (specifically an auto pulse) is in progress? It wasn't for a lack of ability to find the cords as much as it was to maintain the visualization. I think having FD hold the head in line will be my next course since I am not real keen on the idea of stopping compressions for a tube unless I have a supervisor (another medic)who can do the pulse check for me and just do it all at the same time.
VentMonkey
Family Guy
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E-L-M? Also, since you all use an AutoPulse you sit can try to sit the patient upright. Gravity really can be your friend.
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RocketMedic
Californian, Lost in Texas
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I actually prefer the Kingvision's Copilot rigid stylette over the Bougie for video intubations with the unchanneled Kingvision blade. When direct, Bougie every time, but I find myself really, really liking the video scope and I've not used a 'regular' DL for a real tube in nearly a year (skills degradation zone ahead!) Part of that is video-first policy too, but in any event, I find it easier to use the KV than traditional DL.
The data on the elevated intubation is pretty solid, but wasnt there some study on head elevated CPR that popped up a while back?
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Yea I posted the article here a while back. I think it was a study out of Japan
VentMonkey
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//shrugs// And the next cohort will contradict both. Sometimes these studies become overkill. First time success rates with things such as "ramping", bougies, and/ or VL are proven time, and again to improve your chances.
So, at least for me, until the evidence consistently proves detrimental in opposition of any of the above mentioned techniques, certain habits are worth investing in to me.
Published by the fine folks at Jems.
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I've been meaning to try and implement that as well. I might try that along with having an extra set of hands help keep the head stable or just time it with a pulse check. Once I realized I wasn't going to have a stable and consistent view with DL I just ditched that idea and went to 2 person bagging. I know I could have gotten it without the autopulse jerking his head everywhere, but they want us to make an attempt and I'd rather learn how to without stopping what is actually important for the times I am the only medic on scene. Unfortunately this isn't really something I can practice outside of actually doing it and drawing from the experience of others. I'll readjust next time, it won't be long before I have to do it again at this rate.
Jim37F
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Nowhere near as bad as the folks in Texas have it right now, but we're getting enough rain that the entire island is under a flash flood warning
MonkeyArrow
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Eh. There remains an ongoing debate in the critical care circles, specifically, about the ultimate DL vs. VL first pass success rates. Each study that comes out shows one thing or another, but I think the success rates remain very equal in pooled meta-analyses.