Having worked for 4 months in a department that does not see an anaesthetist
week in week out, ( Royal Perth ,Wesern Australia ) and which has perhaps
1 RSI per day performed by Registrars or ED consultants, I would agree that
this is a skill we should make our own, with the caveats of knowling what
to do when things go wrong. Incidentally, fentanyl and midazolam the
preferred pre-suxamethonium cocktail over here, as apparently the least
hypotensive agents.
----- Original Message -----
From: iain jamieson <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, May 07, 2000 6:44 PM
Subject: Re: Pre-Hosp RSI "over there"
>
> Can I just say that I do RSI in A/E and also have done
> them in the field. I agree 150% with what's being
> said, but in terms of skill retention, how are we
> going to persuade hospitals to let us have the
> neccesary time in theatres - when there are already
> anaesthetic SHO's and nurses who need to be trained.
> Also let us not forget that RSI outwith emergency
> theatre and ITU is fairly uncommon. (well ok there's
> A/E too) But this is going to take a lot of man hours
> hanging around waiting for the emergency to happen and
> then....who will do the training ? an anaesthetic
> SHO.....you're unlikely to find a consultant
> immmediately to hand.
> You can go to all the courses in the world but you
> need to practice safely on real patients to be
> profficient.
> If it became common practice in the field and in A/E
> then yes, maybe skill retention wont be problem. If
> enough people feel strongly about it, then let's get
> some ideas as to who would be best placed to deliver
> the training, to whom, and then audit the process
> after a year, lets see the evidence that it makes a
> difference to outcome in the prehospital setting in
> this country. Does anyone have any data I could look
> at ? What about HEMS ? How do they train up their guys
> ?
>
>
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