Troubling rumor about Riverside County, CA

The county had around 14 missed intubation that year
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Compared to how many successful intubations (including successful placements of non-visualized airways and surgical airways)? Without that information, that statistic is effectively meaningless. Also, do you mean "missed intubation" as in "missed esophageal or hypopharyngeal intubation" or in "we didn't get the tube"?
 
14 failed airway (oxygenated by other means)vs 14 missed intubations is a big difference. If it was 14 unrecognized esophageal intubations coming into the ED, not only is this massively unacceptable, it should cause a system to SERIOUSLY consider who's it's certifying to work as a paramedic.

The only number that is acceptable for unrecognized esophageal intubations is 0. Period.
 
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as in the tube was in the wrong hole and they drove all the way to the hospital with it that way. the only other airway they have is the king. no surgical crics. and i dont have the information on the total number of intubation attempts.

edit: also the information given at the same time was that waveform capnography was available in all instances however was not in use.
 
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socalmedic said:
as in the tube was in the wrong hole and they drove all the way to the hospital with it that way.
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Like I said, I support taking away intubation 100%. If you can't be bothered to do any better than this, you don't deserve the procedure.
 
RivCo policy does state that the FD medic should turn over care to the transporting medic as soon as they are done with the task at hand. That being said, there are medics and stations that have a record of not turning over pt care and demanding to ride in with the pt. That's all fine and good, but in the last case(the one that resulted in Peds ET being pulled) the ambo medic stated the tube was bad, the FD medic said it wasn't and that the capnography equipment was wrong, the ambo medic relented and when the pt got to the hospital and the esophageal tube was confirmed, the FD medic blamed the ambo crew for dislodging the tube while moving the pt. Not sure why constant reassessment was not done, but I wasn't there. Waveform capnography is now mandatory on all intubations with accompanying documentation. The problem originally was that not all monitors being used in the county had capnography capability, I believe that has now been rectified, and things are getting at least a little better.
 
jgmedic what is the deal with the egos in Riverside County? I have heard similar things from both EMS and Fire that relationships between the two are less than decent. And the reoccurring factor seems to be the egos between FD and AMR? Any truth behind it?
 
terrible one said:
jgmedic what is the deal with the egos in Riverside County? I have heard similar things from both EMS and Fire that relationships between the two are less than decent. And the reoccurring factor seems to be the egos between FD and AMR? Any truth behind it?
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I personally have only had minor issues with FD medics. As you know Cal Fire has the contract for suppression in the county areas and in many contract cities. The problems I have heard have originated in a few of the contract cities where the FF's hold themselves higher than the AMR guys and do things like try to force the AMR crews to stage outside the door while they do the assessment and any ALS interventions needed. The major issues are also usually between the old-timer AMR medics who have been there long before ALS FD was the norm and still feel like FD has no place in EMS and the FF's who think AMR is no more than gurney jockeys.
 
the station that i was a firefighter explorer for our firefighters seemed to get along with AMR really well. that cant be said for all FF's however. Our station would normally arrive on scene first so we would do all the on scene work. if AMR got there first they would do all the on scene and we would just assist. Our firefighters and medic viewed it as "we know EMS but we are trained on a whole bunch more then that. where as AMR (other ambulance companies) are purely medical so the info is fresher in their minds." we would only have a FF ride with the AMR crew if they asked for someone or if we asked them and they replied yes. however it was not the Firefighter/Medic riding in the ambulance because our Medic was also our Engineer. Its not all firefighters in riverside county that dont get along with AMR (other ambulance companies) just some.
 
Brown does not advocate the removal of endotracheal intubation for Paramedics and has real concern about confounding variables with North American studies fuelling this current debate; for example initial and continuing education, call volume, provider oversaturation and transport time.
 
MrBrown said:
Brown does not advocate the removal of endotracheal intubation for Paramedics
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I don't either assuming the systems put the work in.


MrBrown said:
and has real concern about confounding variables with North American studies fuelling this current debate; for example initial and continuing education, call volume, provider oversaturation and transport time.
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The problem is the confounding variables are the reality of EMS in North America (the US specifically).
 
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