Guest guest Posted December 21, 2003 Report Share Posted December 21, 2003 , Brando et al, Thanks for your comments. These students have no practical experience. They have never (probably) used any of this kit. I only have time to teach them one. 0-100 in 16 hours. They will not get any 'live' practice, hopefully. Skill need to be easily learned, retained, and practical. The question is which one? ET tubes and laryngoscope is top line but more difficult to learn and retain, plus lots of kit. LMAs are easy and quick to learn, but less effective at total airway control. Combi-tubes are somewhere in the middle. For remote use by non medical people, which has the best chance of being used effectively? In a remote situation where advanced airway management is required by non medical staff, is the likely outcome so poor as to make ANY of the above training a waste of time. Would we be better spending precious class time on better splinting, bandaging, infection recognition, or what? As someone said, concentrating on the probable rather than worst case scenarios? I don't mind radical ideas if supported by reason. If you were dropped 50 miles from anywhere with a roll of duck tape and something in your pocket to deal with a serious cas, what would that something be? Christmas cheer Nigel S. mailto: Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2003 Report Share Posted December 21, 2003 Hi Nigel ''If you were dropped 50 miles from anywhere with a roll of duck tape and something in your pocket to deal with a serious cas, what would that something be?'' Me thinks that is would be - A good, reliable, form of communication! (others may not agree in that and op to take a good malt whiskey..!) best wishes re: Remote non-medic , Brando et al, Thanks for your comments. These students have no practical experience. They have never (probably) used any of this kit. I only have time to teach them one. 0-100 in 16 hours. They will not get any 'live' practice, hopefully. Skill need to be easily learned, retained, and practical. The question is which one? ET tubes and laryngoscope is top line but more difficult to learn and retain, plus lots of kit. LMAs are easy and quick to learn, but less effective at total airway control. Combi-tubes are somewhere in the middle. For remote use by non medical people, which has the best chance of being used effectively? In a remote situation where advanced airway management is required by non medical staff, is the likely outcome so poor as to make ANY of the above training a waste of time. Would we be better spending precious class time on better splinting, bandaging, infection recognition, or what? As someone said, concentrating on the probable rather than worst case scenarios? I don't mind radical ideas if supported by reason. If you were dropped 50 miles from anywhere with a roll of duck tape and something in your pocket to deal with a serious cas, what would that something be? Christmas cheer Nigel S. mailto: Member Information: List owner: Ian Sharpe Owner@... Editor: Ross Boardman Editor@... ALL list admin messages (subscriptions & unsubscriptions) should be sent to the list owner. Post message: egroups Please visit our website http://www.remotemedics.co.uk Regards The Remote Medics Team Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2003 Report Share Posted December 21, 2003 I believe the most easy to use and understand device is the LMA. I accept the combitube gives greater airway protection but I also feel there is more trauma potential on insertion and you still have to decide which port to ventilate through. A patient on their side with and LMA is not that unsafe and you can always remove, suck then re-insert with the patient still on their side. At the end of the day in the pre-hosp world the ideal is ETT + a failed intubation/difficult intubation device (whatever that is - combi, AMD, Lary tube, etc) Brando _________________________________________________________________ Tired of 56k? Get a FREE BT Broadband connection http://www.msn.co.uk/specials/btbroadband Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2003 Report Share Posted December 21, 2003 yea but a ET tube is not a nice shinny thing and it doesn't look cool and does not cost a lot of money so it can't be any good! :-) Tom g >From: " Brando Tamayo " <drbcct@...> >Reply- > >Subject: RE: re: Remote non-medic >Date: Mon, 22 Dec 2003 00:57:40 +0000 > >I believe the most easy to use and understand device is the LMA. I accept >the combitube gives greater airway protection but I also feel there is more >trauma potential on insertion and you still have to decide which port to >ventilate through. A patient on their side with and LMA is not that unsafe >and you can always remove, suck then re-insert with the patient still on >their side. At the end of the day in the pre-hosp world the ideal is ETT + >a >failed intubation/difficult intubation device (whatever that is - combi, >AMD, Lary tube, etc) > >Brando > >_________________________________________________________________ >Tired of 56k? Get a FREE BT Broadband connection >http://www.msn.co.uk/specials/btbroadband > > _________________________________________________________________ Tired of slow downloads? Compare online deals from your local high-speed providers now. https://broadband.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2003 Report Share Posted December 22, 2003 Nigel, I personally think that your time would be much better spent on training laypersons in basic life support techniques with minimal adjuncts. All of the devices that you have mentioned require considerable training, skill and practice to use safely. I recomend the use of manual airway manouvres and proper positioning of the patient. Lateral / recovery position is one of the most effective methods for protecting the compromised airway without the use of adjuncts. The only other alternative for a definitive airway is endotracheal intubation (which is way beyond the scope of your audience). Now a lot of people will jump up and down and protest about spinal injury and paralysis. My answer is this: What good is a beautifully stabilised C-spine if the patient aspirates due to a compromised airway. Teach your candidates safe methods of rolling the patient and positioning in the recovery position in order to firstly open, maintain and protect the airway; and secondly to maintain neutral spinal alignment. Kind regards and season's greetings to all, Shaun Ross N Dip A & EC (SA) Date: Sun, 21 Dec 2003 22:15:37 +0000 From: rmo@... Subject: re: Remote non-medic , Brando et al, Thanks for your comments. These students have no practical experience. They have never (probably) used any of this kit. I only have time to teach them one. 0-100 in 16 hours. They will not get any 'live' practice, hopefully. Skill need to be easily learned, retained, and practical. The question is which one? ET tubes and laryngoscope is top line but more difficult to learn and retain, plus lots of kit. LMAs are easy and quick to learn, but less effective at total airway control. Combi-tubes are somewhere in the middle. For remote use by non medical people, which has the best chance of being used effectively? In a remote situation where advanced airway management is required by non medical staff, is the likely outcome so poor as to make ANY of the above training a waste of time. Would we be better spending precious class time on better splinting, bandaging, infection recognition, or what? As someone said, concentrating on the probable rather than worst case scenarios? I don't mind radical ideas if supported by reason. If you were dropped 50 miles from anywhere with a roll of duck tape and something in your pocket to deal with a serious cas, what would that something be? Christmas cheer Nigel S. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 23, 2003 Report Share Posted December 23, 2003 LMA, combitube, EOA, ET tube, Trans-tracheal retrograde wireguided intubation etc etc- How about teaching these people to use one of the simplest, most useful, and life saving airway adjuncts ever invented- a Gaudel airway? Jim re: Remote non-medic , Brando et al, Thanks for your comments. These students have no practical experience. They have never (probably) used any of this kit. I only have time to teach them one. 0-100 in 16 hours. They will not get any 'live' practice, hopefully. Skill need to be easily learned, retained, and practical. The question is which one? ET tubes and laryngoscope is top line but more difficult to learn and retain, plus lots of kit. LMAs are easy and quick to learn, but less effective at total airway control. Combi-tubes are somewhere in the middle. For remote use by non medical people, which has the best chance of being used effectively? In a remote situation where advanced airway management is required by non medical staff, is the likely outcome so poor as to make ANY of the above training a waste of time. Would we be better spending precious class time on better splinting, bandaging, infection recognition, or what? As someone said, concentrating on the probable rather than worst case scenarios? I don't mind radical ideas if supported by reason. If you were dropped 50 miles from anywhere with a roll of duck tape and something in your pocket to deal with a serious cas, what would that something be? Christmas cheer Nigel S. Member Information: List owner: Ian Sharpe Owner@... Editor: Ross Boardman Editor@... ALL list admin messages (subscriptions & unsubscriptions) should be sent to the list owner. Post message: egroups Please visit our website http://www.remotemedics.co.uk Regards The Remote Medics Team Quote Link to comment Share on other sites More sharing options...
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