Hi fred,
Been through the PHTLS manual in detail - the c-spine control and airway techniques are consecutive sections in the book, but not quite complementary - the two airway opening techniques taught are either positioned from above the patient or in front of the patient, but not directly behind.
PHTLS version 5 is current medical standard for CACFOA national extrication challenge.
For interest, most modern extrication fire teams use two medics - the second medic being used as a gofer for the two cutters, fifth person being the team leader.
Quite academic for us, as rare for Fire to be on scene first - they usually hand over medic-side to ourselves PDQ and use their two "medics" as second cutting team for simultaneous cutting activity.
Cheers
Anton
In message <000901c41e5b$a7314de0$0d2c6651@hppav> fred <[log in to unmask]> writes:
> 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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