Re: A simple propostion RE: Wang

[Guest guest]

I'm starting to get worried. Kenny's beginning to make sense, and we really

are not far apart at all in our thinking. Wes makes sense too.

I just wrote an article for upcoming publication on the difficult airway.

One of the reviewers took me to task for talking about the bougie because " most

medics will not know what a bougie is. " The same reviewer took me to task

for mentioning a list of conditions that can make for a difficult intubation,

saying, " Most medics won't know what those terms mean. "

Isn't that sad? He or she is saying that I must dumb down the article

because it might be the first time some of the readers had heard of those

terms.

Does this person not own a dictionary? Do the readers of magazines not

have Google or a dictionary? Or must we assume that they're too dumb to look

something up?

This person also made the comment that anesthesiologists don't know anything

about supraglottic airways. I'm making his sign right now.

GG

In a message dated 11/30/07 2:59:25 PM, kenneth.navarro@...

writes:

>

> >>> I don't like the conclusions of the studies myself.? But instead

> of complaining about the studies, let's try to fix the faults as

> identified. <<<

>

> Wes,

>

> You WERE listening during my portion of the talk!

>

> I think too many of us look for reasons to dismiss the conclusions of

> prehospital EMS research, especially when they conflict with our own

> opinions.

>

> EVERY study has limitations - some more than others. Every author

> has a bias - some more than others. The ethical researchers identify

> the limitations and the bias within the body of the paper, but not in

> the abstract.

>

> I also think that EVERY paper has something to offer. Wang and

> Gausche and and Katz and Mattox and Pepe (can I have a raise

> now) have all identified problems that COULD exist in each of our

> systems.

>

> There are some very valid problems associated with endotracheal

> intubation in the prehospital environment. If we all stick our heads

> in the sand and ignore them because the study was conducted in an

> urban area, or because we don't like Dr. Wang, or because we don't

> agree, then the terrorists win. (Sorry, I didn't have another

> closing for this post.)

>

> Kenny Navarro

> Dallas

>

>

>

**************************************

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[Guest guest]

Bluntly, any medic who doesn't know what a bougie or supraglottic airway is

has ZERO _f$ & @ing_ (mailto:f$ & @ing) business intubating anyone or anything.

Again, until EMS stops just teaching people how to perform skills, and

starts teaching understanding of medicine, we've gone as far as we can go -- and

we're likely getting ready to be restrained in what we can already do.

-Wes Ogilvie, MPA, JD, LP

In a message dated 11/30/2007 6:46:12 P.M. Central Standard Time,

wegandy1938@... writes:

I'm starting to get worried. Kenny's beginning to make sense, and we really

are not far apart at all in our thinking. Wes makes sense too.

I just wrote an article for upcoming publication on the difficult airway.

One of the reviewers took me to task for talking about the bougie because

" most

medics will not know what a bougie is. " The same reviewer took me to task

for mentioning a list of conditions that can make for a difficult

intubation,

saying, " Most medics won't know what those terms mean. "

Isn't that sad? He or she is saying that I must dumb down the article

because it might be the first time some of the readers had heard of those

terms.

Does this person not own a dictionary? Do the readers of magazines not

have Google or a dictionary? Or must we assume that they're too dumb to look

something up?

This person also made the comment that anesthesiologists don't know anything

about supraglottic airways. I'm making his sign right now.

GG

In a message dated 11/30/07 2:59:25 PM, _kenneth.navarro@..._

(mailto:kenneth.navarro@...)

writes:

>

> >>> I don't like the conclusions of the studies myself.? But instead

> of complaining about the studies, let's try to fix the faults as

> identified. <<<

>

> Wes,

>

> You WERE listening during my portion of the talk!

>

> I think too many of us look for reasons to dismiss the conclusions of

> prehospital EMS research, especially when they conflict with our own

> opinions.

>

> EVERY study has limitations - some more than others. Every author

> has a bias - some more than others. The ethical researchers identify

> the limitations and the bias within the body of the paper, but not in

> the abstract.

>

> I also think that EVERY paper has something to offer. Wang and

> Gausche and and Katz and Mattox and Pepe (can I have a raise

> now) have all identified problems that COULD exist in each of our

> systems.

>

> There are some very valid problems associated with endotracheal

> intubation in the prehospital environment. If we all stick our heads

> in the sand and ignore them because the study was conducted in an

> urban area, or because we don't like Dr. Wang, or because we don't

> agree, then the terrorists win. (Sorry, I didn't have another

> closing for this post.)

>

> Kenny Navarro

> Dallas

>

>

>

**************************************

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products.

(_http://money.http://money.<WBhttp://money.http://monhttp://money.<WBhttp_

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[Non-text portions of this message have been removed]

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[Guest guest]

>>> I don't like the conclusions of the studies myself.? But instead

of complaining about the studies, let's try to fix the faults as

identified. <<<

Wes,

You WERE listening during my portion of the talk!

I think too many of us look for reasons to dismiss the conclusions of

prehospital EMS research, especially when they conflict with our own

opinions.

EVERY study has limitations - some more than others. Every author

has a bias - some more than others. The ethical researchers identify

the limitations and the bias within the body of the paper, but not in

the abstract.

I also think that EVERY paper has something to offer. Wang and

Gausche and and Katz and Mattox and Pepe (can I have a raise

now) have all identified problems that COULD exist in each of our

systems.

There are some very valid problems associated with endotracheal

intubation in the prehospital environment. If we all stick our heads

in the sand and ignore them because the study was conducted in an

urban area, or because we don't like Dr. Wang, or because we don't

agree, then the terrorists win. (Sorry, I didn't have another

closing for this post.)

Kenny Navarro

Dallas

[Guest guest]

In keeping with the theme of your email's closing, all I can say is that

improving our airway management (NOT JUST INTUBATION) is a matter of homeland

security.? (Remember kids, " Homeland Security " is Standard Excuse 7-A-4.1 for

implementing any policy or change in policy when you don't want to be blamed

and/or responsible.)

Seriously, how many people in EMS have " blown off " the studies about airway

management with the dismissive claim of " I never miss. " ? That person is either

lying, delusional, or has never intubated in the field.? Kenny is right.?

Continual ignoring of the problem of airway management will ensure only one

thing -- that medical directors will, faced with few other options, make real

the self-actualizing prophecy of paramedics losing intubation as a skill.

-Wes Ogilvie, MPA, JD, LP

-Attorney/Licensed Paramedic

-Licensed and sanitized for your protection

Re: A simple propostion RE: Wang

>>> I don't like the conclusions of the studies myself.? But instead

of complaining about the studies, let's try to fix the faults as

identified. <<<

Wes,

You WERE listening during my portion of the talk!

I think too many of us look for reasons to dismiss the conclusions of

prehospital EMS research, especially when they conflict with our own

opinions.

EVERY study has limitations - some more than others. Every author

has a bias - some more than others. The ethical researchers identify

the limitations and the bias within the body of the paper, but not in

the abstract.

I also think that EVERY paper has something to offer. Wang and

Gausche and and Katz and Mattox and Pepe (can I have a raise

now) have all identified problems that COULD exist in each of our

systems.

There are some very valid problems associated with endotracheal

intubation in the prehospital environment. If we all stick our heads

in the sand and ignore them because the study was conducted in an

urban area, or because we don't like Dr. Wang, or because we don't

agree, then the terrorists win. (Sorry, I didn't have another

closing for this post.)

Kenny Navarro

Dallas

________________________________________________________________________

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[Guest guest]

In a message dated 11/30/2007 3:03:56 P.M. Central Standard Time,

ExLngHrn@... writes:

I don't like the conclusions of the studies myself.? But instead of

complaining about the studies, let's try to fix the faults as identified.

Now that's a concept, look to fix the issues that are the ones that

ultimately hurt the System and oh yea them pesky pain in the but Patients.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

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[Guest guest]

In a message dated 11/30/2007 6:46:03 P.M. Central Standard Time,

wegandy1938@... writes:

I just wrote an article for upcoming publication on the difficult airway.

One of the reviewers took me to task for talking about the bougie because " most

medics will not know what a bougie is. " The same reviewer took me to task

for mentioning a list of conditions that can make for a difficult intubation,

saying, " Most medics won't know what those terms mean. "

Is he right? Do " most medics " fit his descriptions? If so whose fault is

that?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

**************************************Check out AOL's list of 2007's hottest

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[Guest guest]

In a message dated 11/30/2007 6:46:03 P.M. Central Standard Time,

wegandy1938@... writes:

This person also made the comment that anesthesiologists don't know anything

about supraglottic airways. I'm making his sign right now.

now on that point I gotta give you the nod, hell 75% of the time I spent in

the OR watching and playing with airways the guys with MD and DO and CRNA on

their shirts were doing supraglottic and avoiding ETI when they could.

The head of the Anesthesia Group here said and I qoute " the only Gold

Standard I care about is my Patient getting the air they need "

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

**************************************Check out AOL's list of 2007's hottest

products.

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[Guest guest]

Well, at the recent conference I taught 120 people including 6 from

Switzerland to do difficult and surgical airways, and all of them knew what a

bougie

was.

GG

>

>

>

> In a message dated 11/30/2007 6:46:03 P.M. Central Standard Time,

> wegandy1938@wegandy writes:

>

> I just wrote an article for upcoming publication on the difficult airway.

> One of the reviewers took me to task for talking about the bougie because

> " most

> medics will not know what a bougie is. " The same reviewer took me to task

> for mentioning a list of conditions that can make for a difficult

> intubation,

> saying, " Most medics won't know what those terms mean. "

>

> Is he right? Do " most medics " fit his descriptions? If so whose fault is

> that?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Owner and President of LNM Emergency Services Consulting Services (LNMECS)

> Freelance Consultant/Trainer/ Freelance Cons Freelance Consultant/Traine

>

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********<wbr>*********<wbr>

> *

> products.

> (http://money.http://money.<wbhttp://money.http://monhttp://money.<wbhttp)

>

>

[Guest guest]

That sums it up. I get sick of folks talking about this or that not being a

" definitive airway " when they haven't read the studies on LMA or Combitube.

There's NO " definitive airway " device.

Airway is about ventilation, not intubation.

GG

> The head of the Anesthesia Group here said and I qoute " the only Gold

> Standard I care about is my Patient getting the air they need "

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Owner and President of LNM Emergency Services Consulting Services (LNMECS)

> Freelance Consultant/Trainer/ Freelance Cons Freelance Consultant/Traine

>

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********<wbr>*********<wbr>

> *

> products.

> (http://money.http://money.<wbhttp://money.http://monhttp://money.<wbhttp)

>

>

[Guest guest]

In a message dated 11/30/2007 10:43:43 P.M. Central Standard Time,

wegandy1938@... writes:

Well, at the recent conference I taught 120 people including 6 from

Switzerland to do difficult and surgical airways, and all of them knew what

a bougie

was.

But as has been pointed out by the esteemed Mr. Grayson on some thread those

folks are not " most Medics " now are they?

One of the books I looked for and even made a point to ask for was the SLAM

text as I I want to know everything I can about A so that I can do B as C is

really kind of easy if you think about it and BLS always come before ALS in

most cases.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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[Guest guest]

Gene,

I believe there are probably still several areas that are unfamiliar with a

Bougie. I have discovered there are many areas/people who still do not know what

a King LT is.

BTW...send me your address? I have that new airway I was going to give you in

Texas and I'll send it to you..it is called an Air Q...invented by an

anesthetist at the University of Iowa...Dr. Cook.

Jules

Re: Re: A simple propostion RE: Wang

Well, at the recent conference I taught 120 people including 6 from

Switzerland to do difficult and surgical airways, and all of them knew what a

bougie

was.

GG

>

>

>

> In a message dated 11/30/2007 6:46:03 P.M. Central Standard Time,

> wegandy1938@wegandy writes:

>

> I just wrote an article for upcoming publication on the difficult airway.

> One of the reviewers took me to task for talking about the bougie because

> " most

> medics will not know what a bougie is. " The same reviewer took me to task

> for mentioning a list of conditions that can make for a difficult

> intubation,

> saying, " Most medics won't know what those terms mean. "

>

> Is he right? Do " most medics " fit his descriptions? If so whose fault is

> that?

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/ FF/

> Owner and President of LNM Emergency Services Consulting Services (LNMECS)

> Freelance Consultant/Trainer/ Freelance Cons Freelance Consultant/Traine

>

> LNMolino@...

>

> (Cell Phone)

> (IFW/TFW/FSS Office)

> (IFW/TFW/FSS Fax)

>

> The comments contained in this E-mail are the opinions of the author and the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

> unless I

> specifically state that I am doing so. Further this E-mail is intended only

> for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain by

> the

> original author.

>

> ************ ******** ******** ************<wbr>*********<wbr>*********<wbr>

> *

> products.

> (http://money.http://money.<wbhttp://money.http://monhttp://money.<wbhttp)

>

>

[Guest guest]

We have had pictures and narrative of the Bougie in the last two editions of

our paramedic books.

BEB

From: texasems-l [mailto:texasems-l ] On

Behalf Of lnmolino@...

Sent: Friday, November 30, 2007 10:35 PM

To: texasems-l

Subject: Re: Re: A simple propostion RE: Wang

In a message dated 11/30/2007 6:46:03 P.M. Central Standard Time,

wegandy1938@... <mailto:wegandy1938%40aol.com> writes:

This person also made the comment that anesthesiologists don't know anything

about supraglottic airways. I'm making his sign right now.

now on that point I gotta give you the nod, hell 75% of the time I spent in

the OR watching and playing with airways the guys with MD and DO and CRNA on

their shirts were doing supraglottic and avoiding ETI when they could.

The head of the Anesthesia Group here said and I qoute " the only Gold

Standard I care about is my Patient getting the air they need "

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@... <mailto:LNMolino%40aol.com>

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

**************************************Check out AOL's list of 2007's hottest

products.

(http://money.aol.com/special/hot-products-2007?NCID=aoltop00030000000001)

[Guest guest]

Bougie is a great aid. As an EMT-I I am familiar with it. Why would

anyone choose to leave any option that can ensure a good outcome for

the patient out of their bag of tricks? In school when we were

taught to use it I actually thought why attempt any intubation w/o

it. Based on some other responses it sounds as if some have not

stayed current on the latest techniques. Just my thoughts.

Renny Spencer

EMT-I

Fort Stockton EMS

>

> Well, at the recent conference I taught 120 people including 6 from

> Switzerland to do difficult and surgical airways, and all of them

knew what a bougie

> was.

>

> GG

>

>