Robbie
few things first, I'm quite happy at my pre-hospital experience, that I was
not questioning for myself, Could you say that you could teach this to
Firemen?? Remember who is recieving this training and level of expertise!
Secondly- where is this taught, Head position, Head tilt -chin lift and jaw
thrust laying down or in front is only ever been taught on any courses that
I've been on and know off, Any reference for this?
Thirdly, Not ban these but to stop the teaching of this from behind, could
you stand up and account for your actions on an airway technique that is not
normally taught. after all, there is normally five FF's on a pump, so why
put it on to one person to mange the airway and try his best at twisting,
stretching trying to keep head in natural and list and observe the airway
Yes we all have to make do in some extreme situations, but not the normal
everyday work
Fred
----- Original Message -----
From: Robbie Coull
To: [log in to unmask]
Sent: Friday, April 09, 2004 4:22 PM
Subject: Re: Airway technique??
> Ban or stop teaching jaw trust from rear using one person, but need
> reference or professional opinion to help justify this
Fred,
How much pre-hospital experience and training have you had?
It is perfectly possible to hold the head in neutral alignment with the
thumb, index and middle fingers while using the ring and little fingers to
exert jaw thrust from behind (pressing forward on the jaw below the TM joint
on either side).
In fact, this often produces less movement of the neck than a traditional
jaw thrust from the front (which is more common in non-trauma situations).
Airway/breathing assessment is based on look, listen, feel. It is possible
to observe the rate of breathing, and listen for sounds of obstruction from
this position. With enough space (and safety helmets permitting!) it is
also possible to place your cheek close enough to their neck to feel
transmitted noise.
Obviously, during an extrication the noise of the environment (usually dark)
restricts this assessment, and so sao2 and regular observation from the
front would be nice, but it depends on the access to the patient and the
number of people available to assist.
On one occasion I have had to cradle the head of the casualty from behind
(with the help of a head rest) whilst attempting to use a bag and mask at
the same time. This was due to extreme access problems during one part of
the extrication.
Although it is important that responders understand the problems and
limitations involved, I think it would be extremely unwise to attempt to
'ban' these techniques.
--
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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