New Poll

[Guest guest]

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Of all services who perform RSI - how many medics responsible for administration

of succs , vec, or pav really know the complete drug monographs. If drug

monograph information can demonstrated, I would think that RSI would be utilized

less. Instead, most education about RSI is related to a 'cocktail' type

approach rather than a huge dynamic. That's why most medics perform RSI for

questionable reasons at times. Also, it's not only missed intubations that

results in RSI deaths, it's also the medications.

-MH

________________________________

From: texasems-l [texasems-l ] On Behalf Of

Almand [jalmand@...]

Sent: Sunday, April 27, 2008 2:52 PM

To: texasems-l

Subject: New Poll

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Just because your scared to use it don't mean its not a good tool for medic who

need it, like us in east texas who is far away from hospitals. We use it, its a

good and needed tool. Some peoples on here has forgot or just don't know how it

is on some mva's, seizures, etc. Its airway.

New Poll

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Hey Mike, All do respect, please explain your position for me. Since a monograph

is a detailed essay or book on a very specific, often limited subject. It is

designed to stand alone, and is usually not part of a series, unless the

monograph is being released in several parts. Research libraries usually have a

large collection of monographs, and an academic department at a university may

also have an assortment of monographs published within its subject. In general,

a monograph is very dense with information, and is of little interest to people

outside the field.

In order to gain respect within the academic community and tenure at a major

university, an academic must publish monographs over the course of his or her

life. These scholarly treatises provide evidence that the academic is carrying

out research in the field and analyzing already published information. A

monograph usually brings new light to the subject, and it may contain

breakthrough research. It also further refines the academic specialty of the

author, and establishes the author as an authority on the topic.

Written by S.E. copyright © 2003 - 2008

Thanks,

Chris

Holt wrote:

Just because your scared to use it don't mean its not a good tool for

medic who need it, like us in east texas who is far away from hospitals. We use

it, its a good and needed tool. Some peoples on here has forgot or just don't

know how it is on some mva's, seizures, etc. Its airway.

New Poll

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Meaning drug monograph -

________________________________

From: texasems-l [texasems-l ] On Behalf Of Chris

Weinzapfel [ctacdoc657@...]

Sent: Monday, April 28, 2008 3:01 PM

To: texasems-l

Subject: RE: New Poll

Hey Mike, All do respect, please explain your position for me. Since a monograph

is a detailed essay or book on a very specific, often limited subject. It is

designed to stand alone, and is usually not part of a series, unless the

monograph is being released in several parts. Research libraries usually have a

large collection of monographs, and an academic department at a university may

also have an assortment of monographs published within its subject. In general,

a monograph is very dense with information, and is of little interest to people

outside the field.

In order to gain respect within the academic community and tenure at a major

university, an academic must publish monographs over the course of his or her

life. These scholarly treatises provide evidence that the academic is carrying

out research in the field and analyzing already published information. A

monograph usually brings new light to the subject, and it may contain

breakthrough research. It also further refines the academic specialty of the

author, and establishes the author as an authority on the topic.

Written by S.E. copyright © 2003 - 2008

Thanks,

Chris

Holt <bassmedic933@...<mailto:bassmedic933%40yahoo.com>> wrote:

Just because your scared to use it don't mean its not a good tool for medic who

need it, like us in east texas who is far away from hospitals. We use it, its a

good and needed tool. Some peoples on here has forgot or just don't know how it

is on some mva's, seizures, etc. Its airway.

New Poll

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Scared.... what? - strange..... Been a medic for 25 years, used it dozens and

dozens of times. Implemented in a services I worked for on the admin level.

We must have upgraded levels of education and standards to use it more

effectively. If not, we get bad results. That's when we need to be scared....

Interesting use of East Texas lingo, ....

-MH

________________________________

From: texasems-l [texasems-l ] On Behalf Of

Holt [bassmedic933@...]

Sent: Monday, April 28, 2008 11:17 AM

To: texasems-l

Subject: RE: New Poll

Just because your scared to use it don't mean its not a good tool for medic who

need it, like us in east texas who is far away from hospitals. We use it, its a

good and needed tool. Some peoples on here has forgot or just don't know how it

is on some mva's, seizures, etc. Its airway.

New Poll

With all this talk about RSI, i put a simple little poll up to see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

Break this down and it's really only two skills we have performed for

years - intubation and drug administration. Granted it's more labor

intensive and you have the unique and critical element of paralysis.

The bottom line is it should be a decision made by the medical director

knowing the capability and training of his/her Medics. Time of transport

also factors in. It should be closely followed and 100% QA performed on

all RSI patients. Waveform capnography on all intubations is a

requirement, not a luxury. It is the only verifiable piece of evidence

that the airway was secured during the entire time of patient contact

and delivery to the ER.

It doesn't happen often, but there are rare instances where it is

needed. If one adopts the mindset of ventilating the patient and

verifying it

Lt. Steve Lemming, AAS, LP

EMS Administration Officer

C-Shift

Azle, Texas Fire Department

This e-mail is confidential and intended solely for the use of the

individual (s) to whom it is addressed. Any views or opinions presented

are solely those of the author and do not necessarily represent those of

The City of Azle or its policies. If you have received this e-mail

message in error, please phone Steve Lemming (817)444-7108. Please also

destroy and delete the message from your computer.

For more information on The City of Azle, visit our web site at:

http://www.cityofazle.org <http://www.cityofazle.org/>

New Poll

With all this talk about RSI, i put a simple little poll up to

see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks

[Guest guest]

I myself agree with others here that say RSI is an EGO thing with

alot of medics. Granted there is a time and place for any type of

treatment, but many medics have lost the ability to step back and

truthfully assess the situation.

I work in a service where our Medical Control Doc has taken the

title " Protocol " out of our treatment guidlines. She has allowed us

the opportunity to actually treat our patients based on our

abilities and knowledge. In essence we have been given the

priviledge of practicing medicine. This latitude does place alot of

responsibility on me as a medic, but I have welcomed it as challenge

to stay proficient and educated on treatment modalities and

information.

Said all of that to say this. Regardless of your view of the

necessity of RSI in your service; don't be a freelance cowboy that

thinks that RSI is a firstline skill to address a compromised

airway. Sedation without paralysis is a viable option.

Side Note: Anyone using combitubes and having the ER docs extubate

the patient immediately upon arrival?

>

> Break this down and it's really only two skills we have performed

for

> years - intubation and drug administration. Granted it's more labor

> intensive and you have the unique and critical element of

paralysis.

>

> The bottom line is it should be a decision made by the medical

director

> knowing the capability and training of his/her Medics. Time of

transport

> also factors in. It should be closely followed and 100% QA

performed on

> all RSI patients. Waveform capnography on all intubations is a

> requirement, not a luxury. It is the only verifiable piece of

evidence

> that the airway was secured during the entire time of patient

contact

> and delivery to the ER.

>

> It doesn't happen often, but there are rare instances where it is

> needed. If one adopts the mindset of ventilating the patient and

> verifying it

>

> Lt. Steve Lemming, AAS, LP

> EMS Administration Officer

> C-Shift

> Azle, Texas Fire Department

>

> This e-mail is confidential and intended solely for the use of the

> individual (s) to whom it is addressed. Any views or opinions

presented

> are solely those of the author and do not necessarily represent

those of

> The City of Azle or its policies. If you have received this e-mail

> message in error, please phone Steve Lemming (817)444-7108. Please

also

> destroy and delete the message from your computer.

>

> For more information on The City of Azle, visit our web site at:

> http://www.cityofazle.org <http://www.cityofazle.org/>

>

>

>

>

>

> New Poll

>

> With all this talk about RSI, i put a simple little poll up

to

> see who

> does and does not have RSI. Also, there is a choice for

Rural or

> Urban. Take a sec to check a box. Thanks

>

>

[Guest guest]

Break this down and it's really only two skills we have performed for

years - intubation and drug administration.

I can see what you mean by this...but there is one critical difference.? All

those medications we've been giving for years do not actually put the life of

our patient in our hands each and everytime we administer it....and until RSI,

most of those intubations we did were on already dead people....or at least we

didn't have to create a condition that if we didn't perform perfectly....the

patient wouldn't die as a result of our treatment.?

Add to this a true lack of ability to critically think, and RSI can be (and is

often) a dangerous tool.? Without the right training, the right maturity, the

right equipment and attempting to do it outside of the right situation will lead

to continued failures and a continued degrading of the respect our profession

receives.

Dudley

New Poll

With all this talk about RSI, i put a simple little poll up to

see who

does and does not have RSI. Also, there is a choice for Rural or

Urban. Take a sec to check a box. Thanks