> IM Sux (or IV Sux) alone in this setting is not only dangerous but inhumane.
> Alternatives for those experienced in the technique would include
> inhalational induction with sevoflurane but I accept this is dangerous as
> well and not without its own problems.
Hypoxia in the presence of a head injury for 30 minutes in an Emergency
Department is also inhumane. Will the patient have conscious awareness?
> What has happened to the primary surgical airway? The technique I would
have
> used in the field (if possible, which I accept may not have been in this
> case) or on arrival at A&E would have been the good old surgical
> cricothyroidotomy. Effective, quick and likely to give you a much higher
> SpO2 much more quickly than looking for IV access.
I agree, provided that patient movement could be controlled sufficiently for
the procedure.
Best wishes
Darren
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