ET tube versus dual-lumen

[dougd]

Interesting question from another thread that got me to thinking... "Wouldn't a PARAMEDIC use a ET tube rather than a combi-tube?" In Ohio, while intubation is listed under the basic's scope of practice, I don't know of a medical director around here that allows a basic to intubate - so my experience is limited to those few times on the dummy. So i defer to the experts, and maybe I'll learn a thing or three in the process:

Given the research statistics* that would seem to show many pre-hospital providers are misplacing ETT's, do you ever consider using a dual-lumen in place of an ETT when the need arises? Are there times or scenarios where you would try a dual-lumen first before reaching for the laryngoscope? Is your service using waveform capnography or those little disposable in-line CO2 detectors (yeah, real technical name, I know...)?

Also, how much ego is involved in our patient care choices? Are we (as a profession) being obstinate and insisting on tubing patients where a dual-lumen device would be sufficient because we don't want to get laughed at by the other EMT(P)'s when we walk in the ER?

*

http://www.pulmonaryreviews.com/may01/pr_m..._misplaced.html

http://www3.interscience.wiley.com/cgi-bin...823709/PDFSTART

[chbare]

You may want to do a quick search. This topic has been covered, debated, and argued. In addition, specific threads cover specific devices. These may answer your question.

Take care,

chbare.

[dougd]

I probably should have thought of that... nevemind me. :-)