May 21, 2012

The death of pre-hospital intubation

No way Sean! Say it aint so!

Unfortunately this could be a reality in the near future. In California, there is a large push to pull intubation from the scope of paramedics. In L.A. County, they already removed pediatric intubation. Many of the “higher-ups” are starting to think that the skill is unnecessary in a pre-hospital setting.  Some actually believe that intubation is too risky to be performed by paramedics. Scary thought huh?

This all sparked from a couple EMS systems (I wont mention names) that have a big problem with intubation. Success rates averaging around 60% in these areas having raised quite a few eyebrows. Unfortunately these areas make up a large portion of the state. While it is clear that some areas have a problem, I think that this is the wrong way to go about fixing it.

This trend of “dumbing down” EMS really troubles me. I can’t think of any other profession that takes away responsibilities at the first sign of incompetence. I wouldn’t want cops to have their guns taken away for having a bad day at the range. I would expect that the areas of deficiency be addressed by training, refresher courses, skills labs, etc.

Intubation is an extremely valuable procedure that we do. I mean sure, secondary airways like Combitubes or King Airways WORK but they are counter productive when the receiving ER doc pulls them immediately upon arrival to place an ET tube. It is not a difficult skill and there is absolutely no reason why we can’t be proficient at it.

I know that a lot of this is just talk right now, but it scares me to think that our leaders are even considering it. I want to see EMS continue to move forward and advance. This is certainly not the way to do it.