akflightmedic Posted October 5, 2007 Share Posted October 5, 2007 Fire guy...you have no clue what you are talking about. You need to go do some homework. A lot of your answers sound like google textbook responses and your information is inaccurate. I smell a troll. Surgical airways are very easy and quick too. I can have a surgical airway done faster than a needle cric. And yes we do perform surg crics in the field, I have done a few in Florida and a few in Alaska. It is permitted in many, many states, FYI.... By the way, the National Registry does not set the guidelines for what a medic can and can not do in the field. Get a clue brother. Link to comment Share on other sites More sharing options...
Scaramedic Posted October 5, 2007 Share Posted October 5, 2007 A surgical airway is NOT easier nor is it faster, there is a high chance of bleeding into the trachea, and a whole plethora of other reasons that should NOT be performed unless 1) if a doctor is doing it in the field, or 2) a doctor says you can do it in the field. That is a skill that you and your command doc must sit face to face, and you must practice in front of him/her numerous times before he/she says yes. Then you must get past your regional ems office. In no state that I know of, you can perform that skill. If we cant do it as NREMT-P's than you CANT do it in the US. Once again your ignorance is showing, we do surgical crics in Washington. Also NREMT has nothing to do with state and local protocol. It is a testing agency, pure and simple. Maybe if you were even a Nationally Registered Basic you would know that. Peace, Marty Link to comment Share on other sites More sharing options...
Scaramedic Posted October 5, 2007 Share Posted October 5, 2007 Great minds think alike AK. Peace Brother, Marty Link to comment Share on other sites More sharing options...
reaper Posted October 5, 2007 Share Posted October 5, 2007 Dude, We have been doing surgical crics for a long time, as a last resort airway. Needle cric went out of practice years ago. You cannot provide enough ventilation through a 14 ga cath. Link to comment Share on other sites More sharing options...
medic001918 Posted October 5, 2007 Share Posted October 5, 2007 A surgical airway is NOT easier nor is it faster, there is a high chance of bleeding into the trachea, and a whole plethora of other reasons that should NOT be performed unless 1) if a doctor is doing it in the field, or 2) a doctor says you can do it in the field. That is a skill that you and your command doc must sit face to face, and you must practice in front of him/her numerous times before he/she says yes. Then you must get past your regional ems office. In no state that I know of, you can perform that skill. If we cant do it as NREMT-P's than you CANT do it in the US. You sir, are wrong in this case. I have it on standing order to perform a surgical cric. Here's the link to my regional protocols. http://www.northcentralctems.org/documents...20Protocols.pdf. Feel free to read them if you wish. Shane NREMT-P Link to comment Share on other sites More sharing options...
spenac Posted October 5, 2007 Share Posted October 5, 2007 A surgical airway is NOT easier nor is it faster, there is a high chance of bleeding into the trachea, and a whole plethora of other reasons that should NOT be performed unless 1) if a doctor is doing it in the field, or 2) a doctor says you can do it in the field. That is a skill that you and your command doc must sit face to face, and you must practice in front of him/her numerous times before he/she says yes. Then you must get past your regional ems office. In no state that I know of, you can perform that skill. If we cant do it as NREMT-P's than you CANT do it in the US. Actually standard of care is to start with 14g to allow some airway then while your partner bags, you should get your surgical cric gear ready, then remove 14g and start the minor surgery. The 14g will not buy more than 5 minutes. Also you really should have 2 14g to do proper needle cric, the second with a flutter valve to allow proper air exchange, other wise your just building pressure. We do surgical crics all the time in Texas, care to come let me practice on you :shock: . Please don't use blanket BS unverified statements. Now there are even surgical cric sets designed to limit the cut and bleeding. Anyone that uses NR as basis for argument loses all credibility in my eyes. They are only providers of a joke of a test, nothing more. Yes I have NR so I know of what I speak. Have a nice day. Link to comment Share on other sites More sharing options...
firefighter523 Posted October 5, 2007 Share Posted October 5, 2007 Just because you are allowed to do them, doesn't make it safe, or SMART!! You are your own country. There are alot of devices out there that are alot safer , provide just as wide an airway, and are alot faster (quick trach). I would love to be the fly on the wall when you do it causing a pt to aspirate blood, making his condition worse, because I am sure you practice so much. Says alot about your ems system!! Come up with the times, it is NOT advisable out in the field, but then again, you do live in Texas!! Link to comment Share on other sites More sharing options...
medic001918 Posted October 5, 2007 Share Posted October 5, 2007 I live in Connecticut, where we can perform them as well. Does our system suck too for allowing them? One service I work for uses the surgical procedure, while another uses the Melker airway kit. Both are effective when needed to be used. I like how quickly you changed from no state allows it to be done, to it's not smart to do them. That's an interesting dodge to avoid admitting you're wrong. The procedure is not benign, but it's also a "last resort" procedure. At that point, the risk of aspiration outweighs the consequence of having no airway. It's not like you go into a call and start with the surgical airway. They can, and do have their application in perhospital care. Shane NREMT-P Link to comment Share on other sites More sharing options...
Scaramedic Posted October 5, 2007 Share Posted October 5, 2007 What do you guys think about preventing the above situations from occurring? I mean best answer would probably be a restructuring of the paramedic school programs and having concurrent ride-alongs during class, but what about within our current system. Hey Anthony, sorry your post got lost in all the stupidity. The answer could be a program like some hospitals are doing with Nurses. In Portland some hospitals hire Nursing students in their Senior year. They get paid and practice at a level where they get a lot of hands on experience. This preps them to become RN's once they graduate and pass the NCLEX. This is above and beyond the training they are getting in their rotations and gives them experience in their focus of Nursing. The same concept could be applied to EMS in some fashion. Peace, Marty Link to comment Share on other sites More sharing options...
spenac Posted October 5, 2007 Share Posted October 5, 2007 Just because you are allowed to do them, doesn't make it safe, or SMART!! You are your own country. There are alot of devices out there that are alot safer , provide just as wide an airway, and are alot faster (quick trach). I would love to be the fly on the wall when you do it causing a pt to aspirate blood, making his condition worse, because I am sure you practice so much. Says alot about your ems system!! Come up with the times, it is NOT advisable out in the field, but then again, you do live in Texas!! Your ignorance continues to amaze. The device you mention is not considered a needle cric, it is just a variation of a surgical cric, and yes is considered safer. None of our patients have had any complication beyond the scar tissue that occurs. I take it you read about a botched one and decided that all must be bad, or maybe you were the one from that story. If a person has no airway they die. A surgical cric gives them an airway. Actually I am thankful I am in a system that allows use to have a chance to help a person. Our system is progressive, maybe you should get an education and see if you can help yours come out of the stone age. Link to comment Share on other sites More sharing options...
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