Jump to content


Photo

Rapid Sequence Airway


  • Please log in to reply
4 replies to this topic

#1 flychief83

flychief83

    Newbie

  • Members
  • Pip
  • 1 posts

Posted 17 March 2015 - 12:42 AM

Recently our Duel Paramedic Rotor wing flight service has decided to change from Rapid Sequence Induction to Rapid Sequence Airway with the Air Q subglottic airway due to prolonged scene times and De sat values. We have decided to use Ketamine and Rocuronium specifically for our protocol. I am trying to write a all encompassing protocol from BLS all the way through surgical cric. I am looking for any service that has a like protocol for some assistance.


  • 0

#2 B. Cornelius RN EMT-P

B. Cornelius RN EMT-P

    Advanced Member

  • Members
  • PipPipPip
  • 39 posts

Posted 19 March 2015 - 01:03 AM

This post brings up a ton of questions.  It would seem from your post they are taking away your ability to intubate because you take too long and your patients desaturate.  The Air Q is an LMA which does not provide a patent airway which is needed in 99% of patients cared for in the air medical environment.  If they are taking away your ability to RSI then they should take away the paralytics as well.  Using ketamine and rocuronium to partially secure an airway is a horrible idea.  To place an LMA you just need to blunt their reflexes a little with some propofol, paralytics are unneccesary and rarely used with LMAs.  Ketamine does not provide enough sedation and muscle relaxation to place an LMA in most patients, I'd pick another agent.  However the root of my post is that if your intubation skills are that poor you should not be giving anyone any medications to secure an airway, especially a less than ideal one.


  • 0

#3 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 19 March 2015 - 04:52 PM

Recently our Duel Paramedic Rotor wing flight service has decided to change from Rapid Sequence Induction to Rapid Sequence Airway with the Air Q subglottic airway due to prolonged scene times and De sat values. We have decided to use Ketamine and Rocuronium specifically for our protocol. I am trying to write a all encompassing protocol from BLS all the way through surgical cric. I am looking for any service that has a like protocol for some assistance.

 

 

I'm interested in hearing the reasoning behind switching from ETI to LMA placement. Is it supposed to be safer? Quicker? Less desaturation? What is the goal?

 

I do think that LMA's are under-utilized in the prehospital setting, but I also don't think that they necessarily make a good bandaid for poor airway skills or practices.  


  • 0
bring it in for the real thing

#4 brandon911

brandon911

    Advanced Member

  • Members
  • PipPipPip
  • 90 posts

Posted 20 April 2015 - 08:06 PM

I agree with old school.  Training is the key. 

 

brandon911


  • 0

#5 vtach1010

vtach1010

    Advanced Member

  • Members
  • PipPipPip
  • 54 posts

Posted 02 March 2016 - 05:21 AM

We have been using the similar type of process as Flychief83 where we use RSI and drop a Air-Qsp and load up the patient on the aircraft. Once we are on our way to the hospital we have more time to get set up and exchange the LMA out for an actual ETT. We found that we have cut down scene times and increased our first pass success rate since the crews are not so rushed to get a tube on scene but take a moment to get properly set up 


  • 0