Good points Tniuqs though I should of added part of the reason I choose that approach is high probability that we are not going to transport after reviving an OD. More and more I am finding hospitals (who are increasingly overloaded and understaffed) are not appreciating the old approach of bringing the patient back to A to V and then letting them sleep it off in the ER. So more and more I am bringing them back to A&O and letting them decide transport, most are refusing and PD doesn't really give a damn anymore to arrest.
If the Narcan doesn't work then I can upgrade the airway to ETI. I would also like to see some new airways to give us more of a choice. I do not like the new alternatives though, maybe I am to old school.
LMA- Trained in these by an Anesthesiologist who absolutely loved them. Then again he (by his own admission)rarely deals with trauma. I haven't used it yet but I am still a little iffy on it.
King LT - Not in our system yet.
Combitube - My favorite backup, only used it a couple of times though.
PTL - Never used it, not in my system.
Personally I would like to see a combo BVM/Combitube type pharyngeal device, no not an EOA, but something quick and easy to use. Something minimally invasive that can secure the trachea quickly and be used by any level of EMT.
I agree it shoudld not be a protocol issue but a provider using his education and experience to decide the airway. Unfortunately lots of people do not like to use their noodle.
Peace,
Marty