Emergency Airway Management

[tcripp]

In school, we touched on the concept of RSI but never went over procedures, drugs, etc. in depth.

In my service, RSI is in our protocols and, since we are rural, the potential for use is very good.

I'm looking for good sources (book, powerpoint slides, online class, etc) so that I can ensure I know as much as I can about the procedure before my first time.

Any help anyone can provide is more than appreciated.

Toni

[tskstorm]

http://www.scdhec.gov/health/ems/rsi.pdf

http://www.google.com/url?sa=t&source=web&ct=res&cd=11&ved=0CFQQFjAK&url=http%3A%2F%2Fwww.cchseast.org%2FPortals%2F33%2FResidency%2FRapidSequenceIntubation.ppt&ei=d3npS5f0NYH58Abi9bznDg&usg=AFQjCNH124drzgrdC3OI27om99eNiOA_eA

dozens more available on google.

[DartmouthDave]

Hello,

The Difficult Airway textbook has excellent information. It can be a bit of a dry read but quite useful. The depth of information is very good and I think more in depth than what is covered in most Paramedic programs.

Plus, one of the authors (Dr. Murphy) understands EMS very well and if I remember correctly helped develop Emergency Health Services Nova Scotia (EHS NS). Thereby, elevating EMS in the province out of the stone ages and in to an award winning organization.

Looks like a new addition as well.

Difficult Airway Text

An other good book is James Rich's SLAM airway textbook. Covers a huge range of airway management information as well as RSI. Reading wise the writing style is 'lighter' than the Difficult Airway text.

SLAM Airway Text

I hope this helps. Also, as you read up on the subject feel free to start threads on topics you want to discuss or need assistance on. Brain gym is always a good idea.

Both can be ordered online. Also, check your school's library. They may have a copy as well (easier on the budget).

Cheers.....

[tcripp]

http://www.scdhec.gov/health/ems/rsi.pdf

http://www.google.com/url?sa=t&source=web&ct=res&cd=11&ved=0CFQQFjAK&url=http%3A%2F%2Fwww.cchseast.org%2FPortals%2F33%2FResidency%2FRapidSequenceIntubation.ppt&ei=d3npS5f0NYH58Abi9bznDg&usg=AFQjCNH124drzgrdC3OI27om99eNiOA_eA

dozens more available on google.

I know how to Google. I'm looking for personal recommendations. Thanks any way.

Hello,

The Difficult Airway textbook has excellent information. It can be a bit of a dry read but quite useful. The depth of information is very good and I think more in depth than what is covered in most Paramedic programs.

Plus, one of the authors (Dr. Murphy) understands EMS very well and if I remember correctly helped develop Emergency Health Services Nova Scotia (EHS NS). Thereby, elevating EMS in the province out of the stone ages and in to an award winning organization.

Looks like a new addition as well.

Difficult Airway Text

An other good book is James Rich's SLAM airway textbook. Covers a huge range of airway management information as well as RSI. Reading wise the writing style is 'lighter' than the Difficult Airway text.

SLAM Airway Text

I hope this helps. Also, as you read up on the subject feel free to start threads on topics you want to discuss or need assistance on. Brain gym is always a good idea.

Both can be ordered online. Also, check your school's library. They may have a copy as well (easier on the budget).

Cheers.....

Thanks. This sure beats blind searches not to mention the less than 2 pages in my text.

[paramedicmike]

Hello,

The Difficult Airway textbook has excellent information. It can be a bit of a dry read but quite useful. The depth of information is very good and I think more in depth than what is covered in most Paramedic programs.

Plus, one of the authors (Dr. Murphy) understands EMS very well and if I remember correctly helped develop Emergency Health Services Nova Scotia (EHS NS). Thereby, elevating EMS in the province out of the stone ages and in to an award winning organization.

Looks like a new addition as well.

Difficult Airway Text

This.

Take the class as well. Find one and sign up and go. It will be well worth your while.

If, for whatever, reason, you can't take the class, this is the book you need (same as what's referenced above).

[chbare]

Do not take this wrong; however, if you are not aware of good airway resources such as the Ron Walls manual, yuo may not have had much exposure to this area. You stated it was only touched upon in school, yet you will be performing these techniques at your service? The important questions to ask yourself are:

1) Does my service have a comprehensive programme that covers RSI?

2) will I have OR time?

3) do they recommend a specific book for their course and what it is?

4) Will I have extensive, dynamic airway lab scenarios with SIM man and or cadaver exercises?

5) Is a comprehensive QA/QI programme in place?

6) Are there mandatory refresher courses every quarter or so and a minimum number of tubes required along with repeat OR time?

7) Is the proper equipment available such as back up airways, waveform capnography, bougies and so on?

I hope that helps, I would hate to see you set up to fail. RSI is one of the few times where we are given a golden opportunity for a clean kill. Good luck.

Take care,

chbare.

[tskstorm]

Do not take this wrong; however, if you are not aware of good airway resources such as the Ron Walls manual, yuo may not have had much exposure to this area. You stated it was only touched upon in school, yet you will be performing these techniques at your service? The important questions to ask yourself are:

1) Does my service have a comprehensive programme that covers RSI?

2) will I have OR time?

3) do they recommend a specific book for their course and what it is?

4) Will I have extensive, dynamic airway lab scenarios with SIM man and or cadaver exercises?

5) Is a comprehensive QA/QI programme in place?

6) Are there mandatory refresher courses every quarter or so and a minimum number of tubes required along with repeat OR time?

7) Is the proper equipment available such as back up airways, waveform capnography, bougies and so on?

I hope that helps, I would hate to see you set up to fail. RSI is one of the few times where we are given a golden opportunity for a clean kill. Good luck.

Take care,

chbare.

Good summation.

The links I gave you are places that are free to start with, I usually recommend power point slides from temple university which they have for every subject in ems, however they are down for maintainance, been about a month now. As far as specific and personal recommendations:

Richard Beck Pharmacology for the EMS Provider 3 ed.

AAOS Pharmacology applications

AAOS Paramedic Airway management

Benumof Airway Management

Managment of the difficult and failed airway (multiple authors names escape me)

As CH stated though, do you feel confident enough with your limited exposure to perform this procedure just by reading recommended books?

[Aussieaid]

Airway 911

The RSI book on this page by Darren Braude is a really good easy to read and use book. It gives all the concepts and the drugs used as well. Written by an MD/EMT-P who is the medical director for PHI in New Mexico.

I have a couple of other books as well but this one is the most concise, straight to the point and easy to read one.

Cheers!

[tcripp]

Do not take this wrong; however, if you are not aware of good airway resources such as the Ron Walls manual, yuo may not have had much exposure to this area. You stated it was only touched upon in school, yet you will be performing these techniques at your service? The important questions to ask yourself are:

1) Does my service have a comprehensive programme that covers RSI?

2) will I have OR time?

3) do they recommend a specific book for their course and what it is?

4) Will I have extensive, dynamic airway lab scenarios with SIM man and or cadaver exercises?

5) Is a comprehensive QA/QI programme in place?

6) Are there mandatory refresher courses every quarter or so and a minimum number of tubes required along with repeat OR time?

7) Is the proper equipment available such as back up airways, waveform capnography, bougies and so on?

I hope that helps, I would hate to see you set up to fail. RSI is one of the few times where we are given a golden opportunity for a clean kill. Good luck.

Take care,

chbare.

I won't take any of this wrong if you won't take my response as being defensive.

Just because I don't know which resources are regarded as good or better by my peers doesn't mean that I didn't get a good advanced airway education. I've had hands on practice with "live" patients at least 2 dozen times. I've totally lost count on sim man and his amputated cousins (manniquin heads).

I simply feel that when it comes to the specific aspects of rapid sequence intubation (pushing the drugs)...well, I want to get as much additional education as I possibly can. I don't feel like I am beign set up to fail by any means. I just don't want to leave it up to someone else to make sure I know what I need to know when I can be going the extra step to get there.

I hope this explains my intent.

And I do hope to use you all to clarify questions that I might have as I go.

As CH stated though, do you feel confident enough with your limited exposure to perform this procedure just by reading recommended books?

Thanks for the additional comments.

Not sure about confident or not. It's just the drugs I want to understand better.

[DartmouthDave]

Hello,

Also TCRIPP I see that you are in Texas. The SLAM airway course is in the Dallas area. They have a cadaver lab as well (...or when I took it in 2007...).

There were ACP, RN, RT and DR on the course. There were a few complaints from some medics that it didn't focus on the 'street' enough. However, I think they has made up their mind before the course started. In reality, it was a nice mix of hospital, pre-hospital and different professions I found.

Cheers