I've tried a combi-tube in a trapped patient who stopped breathing still
sitting upright in the car - a nasty head injury to boot.
Failed miserably unfortunately, because despite its simplicity (??), in the
heat of the moment it seemed clumsy and awkward.
Blind ET intubation here would be a little risky (someone still needed to
support the C-Spine),
so is a laryngeal mask any good in this situation?? Or should I go on some
more combitube courses!!
Basically if a patient is flat on their back with a clear airway, I'd always
choose ET intubation. Whatever technique is used, its important to be well
practised in that particular one. Pre- hospital care is about establishing
an airway, whereas it can be secured in hospital. In an arrest situation,
I've often done pretty well with just an oral airway. In unconscious
patients with a long transit time to hospital, we want to protect the lungs
from aspiration, and I really would wonder how a LMA does against say an
oral airway with cricoid pressure- does anyone know??
The above are posed as questions rather than authoritative statements!!
Cheers Jeremy BASICS/ SIMCAS
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