> Paramedics in the UK are not doing RSI at the moment. Personally I don't see
> it necessarily as a doctor only skill... but must be done by someone skilled
> who can also deal with the consequences of a failed intubation. This is when
> it can get very stressful even for someone with grey hair like me! I had a
> few more grey hairs after this case.
I was doing a locum in Canada for four months at the end of last year, and
flew about one medivac a week from our small hospital to the larger centre
across the lake in Alberta.
While there is great variability in North America, the paramedics in Alberta
perform RSIs on anyone with significantly reduced ventilation or GCS even
with short transport times. They were performing in excess of one a day
each in Fort MacMurray. They could also perform chest tube insertion,
surgical airways, treat and release and other skills that most UK paramedics
do not possess. They have access to far more drugs as well (eg: adenosine
and thrombolytics).
These differences are linked to the fact that UK paramedics are given a 3
month course while those in the US and Canada have a 3 year course.
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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