Re: [EMS_Research] Re: More Problems with Pedi

[Guest guest]

No one with a functioning brain will dispute the fact that good BLS

airway management to ensure adequate oxygenation and ventilation is

paramount. There are multiple issues here with various opinions and no

clear cut answers.

Lee

Re: [EMS_Research] Re: More Problems with Pedi

Importance: High

Sorry but after 36 years in giving care at all levels I will say one

thing and shut up time is the utmost secondary thing in treating Pedi

pts after a manual provided air way and if procedures delay or prolong

that transport time then you are doing some thing wrong and need to

reevaluate what and how you are doing things and adjust your priorities

Pedi intubations should not be thrown out but manual air way and trans

port should be balanced in 36 years I never lost a Pedi pt that had not

been down for unknown times and that includes times before advanced care

skills and long distant transfers ventilate try ventilate try ventilate

transport and ventilate and deliver and that better be fast. Check pals

and heart association if you disagree with me.

=========================================

[EMS_Research] Re: More Problems with Pedi

>> I agree that the routine intubation of Pedi's in respiratory

failure does not improve outcome over BVM, but should we remove

this technique from the Paramedics " Bag of Tricks " due to it's

overuse in certain circumstances? >>

No, we shouldn't remove it because of its overuse. We should

remove

it because it is ineffective and possibly dangerous. Dr. Gausche-

Hill's study from LA not only found no difference in outcome, but

a

significant number of unrecognized esophageal placements. (I don't

have the study in front of me, but I think it was in the

neighborhood of 20-25% unrecognized misplacements.) BTW, her

study

is not the only one to come to the same conclusion.

Consider this scenario. Your child is critically injured and is

being treated in an emergency room. The physician comes to you

for

permission to perform an emergency procedure. He informs you that

if he performs the procedure, it will provide no survival benefit

for your child but there is a 20-25% chance it will create a

situation from which your child could not possibly survive.

Would you give consent for this procedure to be performed?

Thank you for your time,

Kenny Navarro

[Guest guest]

Gang;

Just got through reading the posts on this matter. I have a question or

two. Are the studies done in the hospital setting (in relation to pediatric

intubations) relaying the same message or are they just the opposite?

Why would it be different in the hospital Vs pre-hospital?

Is this another issue for training?

Questions, questions, questions. Any answers?

Danny L.

Owner/NREMT-P

Panhandle Emergency Training Services And Response

(PETSAR)

Office

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