Currently, I work full-time with an EMT partner. When it comes to airway, I am a believer in prehospital intubation. Though, when a call is out of control, and airway is immediate, I love my back up airways and an aggressive EMT.
Now, with that said, I do not believe that iGel needs to be the first line of airway protection on an ALS truck. If we lose intubation, we lose an amazing tool as paramedics. There are several districts across the United States that are taking intubation away from their medics and handing them the iGel. Their explanation for the decision is simply a lack of education and mistrust from their medical director.
I can understand a medical directors apprehension… While a physician is still paying off their student loans, they have medics out practicing their skills under a license you technically don’t own yet!! So, when you find out that their have been esophageal placements it make them apprehensive to continue granting this skill. But, when I think of a paramedics bread and butter skill, I think of ACLS and advanced airways. If that is our pride in skill, then why our we losing it??
My answer is in three parts; education, practice, and time constraints.
Our short staffing of paramedics nation wide and an ever-growing increase in call volume is currently making us stagnant. As some one who holds an associate degree and expected to make physician like decisions, I want to be as fresh on my skills as possible. Fortunately, I work frequently in education, so I am able to maintain a lot of time in the lab and reading articles. I am extremely grateful for this opportunity. As an educator, I try to get as many crews involved as possible in training and education. If you don’t use the skill you will lose it. Our own apathy is what will destroy our services.
How can we fix this? This a system approach. My system is extremely short-staffed and struggling on paying over time keeping cars on the street, none the less paying over time to keep people in the class room. Granted, we maintain quarterly training and education with acts of miracles.
Managers how a complex role. They have to juggle so many aspects just to keep the base doors open. Though, keeping an understanding of not only keeping employees up to date on their basic skills, but giving them the challenge of advancing their skills and understanding will push our trade even further.