madmedic8522 Posted June 21, 2006 Share Posted June 21, 2006 PRPG, i would guess, and only a guess that there may have been some extensive ETOH abuse, even at the ripe old age of 21. i have always been taught that anytime you introduce an instrument to a body that there is a certain level of trauma involved, and of course one can run the risk of.....I'll just say "over traumatizing" for lack of a better description. It's just one of those things that "could" happen, and that we try our damnedest to avoid it. just my thoughts so far! madmedic Link to comment Share on other sites More sharing options...
RaceMedic Posted June 21, 2006 Share Posted June 21, 2006 My 2 cents about the intubation thing. If he had to jam that hard he was either in the wrong place (did not have good visualization of the cords or had mistaken another part of the anatomy for the cords) or had way to large of a tube. Just a thought. I had never heard of this happening before. Be Safe Race Link to comment Share on other sites More sharing options...
Ridryder 911 Posted June 21, 2006 Share Posted June 21, 2006 I have seen some major soft tissue damage from "deep" looking with laryngoscopes and pushing around the cords. I have only seen one lateral cord tear.. (thank god, it occurred after I left the patient). Subglottic emphysema usually occurs with tracheal ruptures as well. I have seen several of these with residents insisting to over inflate the cuff... sudden sub-q, air escaping above and below the cuff. Usually a trach has to be performed. These are usually the Oh He*l ! scenarios.... R/r 911 Link to comment Share on other sites More sharing options...
Ace844 Posted June 22, 2006 Share Posted June 22, 2006 This is an issue that really grinds my beans. I really bothers me when field crews give D50 for a hypoglycemic while in the house and then wait for the pt to come around and then call for an RMA. Don't give the D50 in the house, wait till you are in the ambulance. The few minutes that it takes to get the pt out of the house. The pt will need to be observed for a while and I just don't trust family members to do it. If they are hypoglycemic due to sulfonylurea use they will need to be admitted for observation at least overnight. Please do your friendly medical control doc a favor and don't give the D50 until you are in the ambulance (unless you can do the RMA without him/her). I will now step off of my soapbox "ERDOC," Here's another interesting article that deals with things we have been discussing here and in other threads:: http://www.findarticles.com/p/articles/mi_...1_4/ai_90987569 Hope this helps, ACE844 Link to comment Share on other sites More sharing options...
PRPGfirerescuetech Posted June 22, 2006 Share Posted June 22, 2006 Quick follow up on the airway issue discussed. 12cm tracheal tear, advised from autopsy type people that was from the intubation attempt, especially after hearing the story. No follow up from ALS coordinator, simple because "it happens" Heavy extensive ETOH history, moreso than originally thought. The 22 year old "friend" with him died of an arrest the following night of (insert gasp here) Herion(sp?)/Fentanyl. Link to comment Share on other sites More sharing options...
ERDoc Posted June 23, 2006 Share Posted June 23, 2006 Quick follow up on the airway issue discussed. 12cm tracheal tear, advised from autopsy type people that was from the intubation attempt, especially after hearing the story. No follow up from ALS coordinator, simple because "it happens" Heavy extensive ETOH history, moreso than originally thought. The 22 year old "friend" with him died of an arrest the following night of (insert gasp here) Herion(sp?)/Fentanyl. 12cm????? :shock: That's no small tear (it's about half the length of the tube) and that takes quite a bit of force. This guy needs a little remediation to say the least. Link to comment Share on other sites More sharing options...
ERDoc Posted June 23, 2006 Share Posted June 23, 2006 How did this thread go from a discussion of glucose/glucgon to a talk about overly aggressive intubations? Link to comment Share on other sites More sharing options...
ERDoc Posted June 23, 2006 Share Posted June 23, 2006 Hey, I now have over 400 posts! Link to comment Share on other sites More sharing options...
paramedicmike Posted June 23, 2006 Share Posted June 23, 2006 Agreed! Remediation is in order to say the least. How about sending the person back to paramedic school!!! This wasn't anyone I know, was it? -be safe. Link to comment Share on other sites More sharing options...
ERDoc Posted June 23, 2006 Share Posted June 23, 2006 Hey, I now have over 400 posts! One more just to post pad. Link to comment Share on other sites More sharing options...
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