So I ran into an interesting scenario today at work. We were on scene at a code and the patient presented with clenched teeth which we had no luck in intubating. We have no RSI protocol in our system... As my partner raced back to the truck to retrieve the cric kit and IO drill (we didn't know we were walking into a code) and the first responders were taking care of BLS I decided I would try the "absolutely contraindicated" nasotrachael intubation of our apneic patient (As an EMT-Intermediate I cannot do surgical airways). It went right in and functioned perfectly within about 8 seconds. My partner finally got back and was was shocked and confused about how it worked with no inspiration to guide it in. I guess I attribute it purely to luck but it got me thinking-- In classes and from talking to MDs and respiratory therapists, you cannot and should not ever try to go nasally with an ET tube on a non breathing patient (indeed I got chewed out at the ER). Does anyone else have any experience on this issue? I know the procedure is not intended for code situations, but it seemed to work so easily and quickly to be so harshly contraindicated in this situation. Obviously if other more reliable and indicated means were available (surgical procedures, RSI, etc.) that would be the better option, but what about if they are not readily at hand or a paramedic level provider is not present?
Edited by twist27896, 04 February 2013 - 06:13 AM.