Intubation

[Mr T]

There has been much talk over the JRCALC information released regarding the ability of paramedics to intubate effectivly, the debate has been raging on for a while now with a number of studies mainly done in the US around paramedic intubation. I know the LAS introduced a good governance system for their paras which ment all tubes were done as a two person job, bougie, ETCO2 etc etc. What are peoples thoughts on this particularly anyone within the LAS.  Where i work we have adopted a similar procedure to the LAS in this regard althoguh im sure that there are some differaces. So whats your thoughts paramedics intubation good bad or what ?

[Stubbsie]

An interesting thought there Mr T, in my experience intubation is one skill that Paramedics take a great pride in carrying out , especially in difficult environments, the thought of JRCALC thinking of withdrawing this skill from future Paramedic Courses is quite worrying to hear.
I appears the average Paramedic only conducts 3 - 4 intubations per year according to articles I have read in the Ambulance press, and on going training I think needs to be carried out within Ambulance Service Training Schools, and also within the Private sector to keep the skill level to a high standard.
Has any other Ambulance Service adopted the LAS system, that you are aware of, I assume you work for the Ambulance Service, and that you've also moving the LAS way ?
Look forward to your comments.

[Boris]

Get an I-Gel you can teach a monkey to place - not even a syringe to over/underinflate and site it.  THEN, take a size 6 ET tube, railroad it down the insufflation port, inflate then venilate.  It will go down the trachea every time.  In the case of narrowed or difficult airways, use the I-Gel as an introducer for the Gum Elastic Bougie.  Once the ET tube is sited, then deompress the stomoach with an NG tube, tape and ties everything off and there was no need for a laryngscope.  Placing the Igel and Tube should take less than 20 secs.  Tying Off 10.  Try it on the manekin.