Intubations for 2009

[stcommodore]

Hey all, with less then a month to go this year how many ETI do you have as an ALS provider?

To expand it further, how many do you average in a month? What do you think the average is for a full time ALS provider? What do you think the minimum standard should be before a provider is sent to an OR/training center to "keep there skills up."

For the record I've had 22 sucessful intubations at a 82% sucess rate.

[DwayneEMTP]

We're required to have one per quarter in the OR under the tutelage of Nurse Anesthetist regardless of our intubations in the field. I thought this was dorky at first, but then I discovered that I learned something from them each time I went in. They are also big fans of EMS so are truly focused on helping us be better providers. We're lucky to have this opportunity.

I've got six oral tubes and one one nasal tube, not counting the OR. Ten/one if OR is counted. Orals 100%, nasal 50%. This is over 6 months, so not quite two per month.

I truly have no idea what the minimum standard should be. I've never really found intubation to be a terribly difficult skill if you're prepared before beginning and use a gentle touch. I'll have to leave the answer to that question to my betters.

No idea what the national average might be.

Dwayne

[Niftymedi911]

I've had 9. (8-1 record, 80% success I guess?). But there have also been (roughly 20-30) calls where I've practiced excellent BLS and there was no further need for anything more advanced. Not to mention our agency is a HUGE user of CPAP. (I think it is one of the most awsome tools for patients in respiratory distress). But in all seriousness, the less invasive for my patient's the better. Do I see where maybe doing them day in and day out would lead to mastering the skill? Yes. But I would have to also agree with Dwayne. It's nothing but a slide, lift, and stick.

[scott33]

Only 6 this year.

[Jwade]

Hey all, with less then a month to go this year how many ETI do you have as an ALS provider?

To expand it further, how many do you average in a month? What do you think the average is for a full time ALS provider? What do you think the minimum standard should be before a provider is sent to an OR/training center to "keep there skills up."

For the record I've had 22 sucessful intubations at a 82% sucess rate.

82%? 22/27 And people wonder why there is so much talk about removing ETI from the paramedic scope of practice. I would hope you are more concerned with the 5 you missed!

To answer your question:

We should accept nothing less than >95% success rate. My last service required 5 live field per quarter, or off to the OR we went.

Respectfully,

JW

[medic82942003]

I worke on a transport ambulance, I am 0-2. Now in my defence both patients had Lividity. Both were at night, and they were african americans, Now I agree about the practice makes perfect. But from what I am

hearing- New ACLS standards say use more time on Defib, O2, king airway and high compression rates. So by the old statdards I basically suck at intubation.

[FireMedic65]

Year total so far... 5,523,624

[Jwade]

I worke on a transport ambulance, I am 0-2. Now in my defence both patients had Lividity. Both were at night, and they were african americans, Now I agree about the practice makes perfect. But from what I am

hearing- New ACLS standards say use more time on Defib, O2, king airway and high compression rates. So by the old statdards I basically suck at intubation.

Just curious as to why you would even attempt to intubate someone with lividity?

What does night and race have to do with your success rate? again, not trying to flame, just curious on your logic.

Thanks

JW

[scott33]

Just curious as to why you would even attempt to intubate someone with lividity?

Just what I was going to ask. There is no cure for death, and even with arrests you should assess before you treat.

[stcommodore]

In regards to those I miss I keep a sort of running tally of each and I believe it was a early year slump for no specific reason. I have had great sucess with some really difficult intubations Ex. 500lb respiratory arrest, multisystem trauma, etc patient's but sometimes you can't get them all. I've used CPAP probaby 5-10 times this year the fact is I see more cardiac arrest patient's then CHF, severe Asthma, etc patient's.

We can also expand this further into first time sucess, and at what point do you stop (three attemps total) and switch to a rescue airway?

I've never personally used a rescue airway but feel that once I arrived at the hospital it would be pulled faster then anything so that 10 more people could make 10 more fruitless attempts.