Dear Ray,
I obviously can't comment on the specifics of an incident, but general principle is that only delay loading a patient for securing of the airway or CPR in progress - all else can be done en route. As such, would entirely agree that is appropriate to delay laoding until RSi has been performed.
Second principle is that if some skill or drug has been performed that is not in the repertoire of the paramedic crew attending, be it pre-hospital thrombolysis by a pre-hosp thrombolysis-trained para or RSI by a doc, then the person who performed the procedure needs to accompany the patient to hosp as the crew may not be able to detect complications arising from the procedure or drug. Less of a problem in our patch where the 135 can take a 3rd medical crew member, but in most areas, using either Squirrels or 105s, that will entail leaving a heli crew member behind.
After much suction angst, we reached the conclusion that only reliable suction is battery-powered - Laerdal, etc. This is going to entail some reconfiguration of the response bags in our service.
Anton
In message <004501c1c7c2$2475d750$0100a8c0@DADS> Ray McGlone <[log in to unmask]> writes:
> Went on a Flying Squad call out on Friday to Yorkshire.... took =
> sometime.
>
> There were two problems:
>
> There was a helicopter and an ambulance there when we arrived. There =
> were 2 serious head and chest injuries.
>
> The helicopter crew wanted to transfer the more seriously injured =
> patient, because it would only be 9 mins flying time. The patient's =
> airway was compromised so I had to do a RSI at the roadside. I ordered =
> the crew to take the other patient who was maintaining his airway, but =
> still needed rapid attention. Does anyone else have this problem with =
> helicopters? Speed is not everything!
>
> Second problem does anyone know of any machine that provides REALLY good =
> suction at the roadside?... please
>
> Regards
>
> Ray McGlone
>
> A&E Consultant
> Royal Lancaster Infirmary / Westmorland General Hospital
>
> http://www.mbha.nhs.uk/morecambe_bay_hospitals_trust.htm
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