Guest guest Posted May 8, 2010 Report Share Posted May 8, 2010 My point exactly, Don. Jane Dinsmore Don Elbert delbert@...> wrote: >Listening to a neurosurgeon in Toronto - head of neurosurgery at huge level I & med school - at a trauma conference a few years ago called the worry about a tube being placed into the brain " BS " (but of course not abbreviated). The point being that if the patient has a hole in their cribiform plate so large that an ETT would pass through it.....they were dead anyway. > >Makes sense. > > > >>>> " Jane Dinsmore " texas.paramedic@...> 5/6/2010 5:06 PM >>> > >My understanding is that nasal intubation in head injuries has become a general consensus " moot point " as there have been no documented cases of nasally intubating the brain in these situations. Has there been some documented evidence that it actually DOES and HAS happened that I missed in the last few years? If so, someone please share it with us. > > > >Jane Dinsmore > > > > >To: texasems-l >From: lnmolino@... >Date: Thu, 6 May 2010 17:31:30 -0400 >Subject: Re: Re: Airway Question > > > > > >So you're older are Ya bragging or complaining. > >Brand new as in NJ went to the 2nd Ed in mid 1981 so it could have been 20 >years old it was new to us > >Also I think it was Brady or maybe a pre-Brady Publisher that in the same >year as that did a Basic book with a set of color plates that were piloted >in some places in NJ same time. we got a look at that and were all a gast at >the color, it was so novel. Again new to NJ in 1981. > >Louis N. Molino, Sr., CET >FF/NREMT-B/FSI/EMSI >Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant > >LNMolino@... > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds >discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > >In a message dated 5/6/2010 4:09:26 P.M. Central Daylight Time, >krin135@... writes: > >pardon, Sir, but the " Orange Book, Second Edition " was *at least* 6 years >old by the time you took your -A course. > >I took my 81 hour -A course in 1976-7 with the Second Edition... and, >IIRC, >we were the second or third class at that training center to use it (St >ph's Hospital Medical Center, Bloomington, IL). > >ck > >In a message dated 5/6/2010 16:03:43 Central Daylight Time, >_lnmolino@..._ (mailto:lnmolino@...) writes: > >Part of the issue here is the 6th edition is a full 4 editions ago. > >Granted even me a Basic knew that nasal intubation was a NO NO in the case >of a skull fracture. > >Oh my EMT-A course in 1981 was with the brand new AAOS 2nd Ed. > >Louis N. Molino, Sr., CET >FF/NREMT-B/FSI/FF/N >Freelance Consultant/Trainer/Freelance Consultant/Trainer/ Freelance > >__LNMolino (AT) aol (DOT) _LN_ (mailto:_LNMolino@...) _ (mailto:_LNMolino@..._ >(mailto:LNMolino@...) ) > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds >discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > >In a message dated 5/6/2010 3:28:09 P.M. Central Daylight Time, >__medic0946 (AT) yahoo (DOT) _me_ (mailto:_medic0946@...) _ >(mailto:_medic0946@..._ (mailto:medic0946@...) ) writes: > >Rick, you were correct. Nasal intubation should be avoided in the >possibility of basal skull fx. > > >> >> Ok group, >> I normally do more reading than talking on here, but I have a question >that is killing my brain, LoL. I'm studying for my NREMTP using the " >Caroline's Emergency Care in the Streets 6th Edition " student workbook. >> >> Under the " Airway Management & Ventilation " chapter the question states, >> >> You have a 42 y/o female extricated from a wrecked vehicle; she is >unconscious and has a depressed skull fracture at the back of her head. To >secure an airway would you choose, >> >> A. Blind nasotracheal intubation as the preferred technique. >> B. Tracheal intubation as the preferred technique. >> C. Cricothyrotomy as the preferred technique. >> >> I chose " B' as my answer, and was told (by the answers in the back of >the book) that the correct answer was " A " . Please correct me if I'm wrong >as >I am still learning, but have we not always been taught NOT to use >nasotracheal intubation if the pt has a skull fracture of any kind? >> >> Everyones input will be greatly appreciated, because I really need to >pass my test. >> >> Thanks, >> R. >> >> Democracy will cease to exist when you take away from those who are >willing to work and give to those who are not. >> Jefferson >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2010 Report Share Posted May 8, 2010 My point exactly, Don. Jane Dinsmore Don Elbert delbert@...> wrote: >Listening to a neurosurgeon in Toronto - head of neurosurgery at huge level I & med school - at a trauma conference a few years ago called the worry about a tube being placed into the brain " BS " (but of course not abbreviated). The point being that if the patient has a hole in their cribiform plate so large that an ETT would pass through it.....they were dead anyway. > >Makes sense. > > > >>>> " Jane Dinsmore " texas.paramedic@...> 5/6/2010 5:06 PM >>> > >My understanding is that nasal intubation in head injuries has become a general consensus " moot point " as there have been no documented cases of nasally intubating the brain in these situations. Has there been some documented evidence that it actually DOES and HAS happened that I missed in the last few years? If so, someone please share it with us. > > > >Jane Dinsmore > > > > >To: texasems-l >From: lnmolino@... >Date: Thu, 6 May 2010 17:31:30 -0400 >Subject: Re: Re: Airway Question > > > > > >So you're older are Ya bragging or complaining. > >Brand new as in NJ went to the 2nd Ed in mid 1981 so it could have been 20 >years old it was new to us > >Also I think it was Brady or maybe a pre-Brady Publisher that in the same >year as that did a Basic book with a set of color plates that were piloted >in some places in NJ same time. we got a look at that and were all a gast at >the color, it was so novel. Again new to NJ in 1981. > >Louis N. Molino, Sr., CET >FF/NREMT-B/FSI/EMSI >Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant > >LNMolino@... > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds >discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > >In a message dated 5/6/2010 4:09:26 P.M. Central Daylight Time, >krin135@... writes: > >pardon, Sir, but the " Orange Book, Second Edition " was *at least* 6 years >old by the time you took your -A course. > >I took my 81 hour -A course in 1976-7 with the Second Edition... and, >IIRC, >we were the second or third class at that training center to use it (St >ph's Hospital Medical Center, Bloomington, IL). > >ck > >In a message dated 5/6/2010 16:03:43 Central Daylight Time, >_lnmolino@..._ (mailto:lnmolino@...) writes: > >Part of the issue here is the 6th edition is a full 4 editions ago. > >Granted even me a Basic knew that nasal intubation was a NO NO in the case >of a skull fracture. > >Oh my EMT-A course in 1981 was with the brand new AAOS 2nd Ed. > >Louis N. Molino, Sr., CET >FF/NREMT-B/FSI/FF/N >Freelance Consultant/Trainer/Freelance Consultant/Trainer/ Freelance > >__LNMolino (AT) aol (DOT) _LN_ (mailto:_LNMolino@...) _ (mailto:_LNMolino@..._ >(mailto:LNMolino@...) ) > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds >discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > >In a message dated 5/6/2010 3:28:09 P.M. Central Daylight Time, >__medic0946 (AT) yahoo (DOT) _me_ (mailto:_medic0946@...) _ >(mailto:_medic0946@..._ (mailto:medic0946@...) ) writes: > >Rick, you were correct. Nasal intubation should be avoided in the >possibility of basal skull fx. > > >> >> Ok group, >> I normally do more reading than talking on here, but I have a question >that is killing my brain, LoL. I'm studying for my NREMTP using the " >Caroline's Emergency Care in the Streets 6th Edition " student workbook. >> >> Under the " Airway Management & Ventilation " chapter the question states, >> >> You have a 42 y/o female extricated from a wrecked vehicle; she is >unconscious and has a depressed skull fracture at the back of her head. To >secure an airway would you choose, >> >> A. Blind nasotracheal intubation as the preferred technique. >> B. Tracheal intubation as the preferred technique. >> C. Cricothyrotomy as the preferred technique. >> >> I chose " B' as my answer, and was told (by the answers in the back of >the book) that the correct answer was " A " . Please correct me if I'm wrong >as >I am still learning, but have we not always been taught NOT to use >nasotracheal intubation if the pt has a skull fracture of any kind? >> >> Everyones input will be greatly appreciated, because I really need to >pass my test. >> >> Thanks, >> R. >> >> Democracy will cease to exist when you take away from those who are >willing to work and give to those who are not. >> Jefferson >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2010 Report Share Posted May 8, 2010 If the mouth is full of brains makes it much easier to oxygenate the grey matter.... Dudley Re: Re: Airway Question > > So you're older are Ya bragging or complaining. > > Brand new as in NJ went to the 2nd Ed in mid 1981 so it could have > been 20 > years old it was new to us > > Also I think it was Brady or maybe a pre-Brady Publisher that in the same > year as that did a Basic book with a set of color plates that were > piloted > in some places in NJ same time. we got a look at that and were all a > gast at > the color, it was so novel. Again new to NJ in 1981. > > Louis N. Molino, Sr., CET > FF/NREMT-B/FSI/EMSI > Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant > > LNMolino@... > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds > discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > > In a message dated 5/6/2010 4:09:26 P.M. Central Daylight Time, > krin135@... writes: > > pardon, Sir, but the " Orange Book, Second Edition " was *at least* 6 years > old by the time you took your -A course. > > I took my 81 hour -A course in 1976-7 with the Second Edition... and, > IIRC, > we were the second or third class at that training center to use it (St > ph's Hospital Medical Center, Bloomington, IL). > > ck > > In a message dated 5/6/2010 16:03:43 Central Daylight Time, > _lnmolino@... _ > (mailto:lnmolino@... ) writes: > > Part of the issue here is the 6th edition is a full 4 editions ago. > > Granted even me a Basic knew that nasal intubation was a NO NO in the > case > of a skull fracture. > > Oh my EMT-A course in 1981 was with the brand new AAOS 2nd Ed. > > Louis N. Molino, Sr., CET > FF/NREMT-B/FSI/FF/N > Freelance Consultant/Trainer/Freelance Consultant/Trainer/ Freelance > > __LNMolino (AT) aol (DOT) _LN_ (mailto:_LNMolino@... > ) _ (mailto:_LNMolino@... > _ > (mailto:LNMolino@... ) ) > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds > discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > > In a message dated 5/6/2010 3:28:09 P.M. Central Daylight Time, > __medic0946 (AT) yahoo (DOT) _me_ (mailto:_medic0946@... > ) _ > (mailto:_medic0946@... _ > (mailto:medic0946@... ) ) writes: > > Rick, you were correct. Nasal intubation should be avoided in the > possibility of basal skull fx. > > > > > > Ok group, > > I normally do more reading than talking on here, but I have a question > that is killing my brain, LoL. I'm studying for my NREMTP using the > " > Caroline's Emergency Care in the Streets 6th Edition " student workbook. > > > > Under the " Airway Management & Ventilation " chapter the question > states, > > > > You have a 42 y/o female extricated from a wrecked vehicle; she is > unconscious and has a depressed skull fracture at the back of her > head. To > secure an airway would you choose, > > > > A. Blind nasotracheal intubation as the preferred technique. > > B. Tracheal intubation as the preferred technique. > > C. Cricothyrotomy as the preferred technique. > > > > I chose " B' as my answer, and was told (by the answers in the back of > the book) that the correct answer was " A " . Please correct me if I'm wrong > as > I am still learning, but have we not always been taught NOT to use > nasotracheal intubation if the pt has a skull fracture of any kind? > > > > Everyones input will be greatly appreciated, because I really need to > pass my test. > > > > Thanks, > > R. > > > > Democracy will cease to exist when you take away from those who are > willing to work and give to those who are not. > > Jefferson > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 8, 2010 Report Share Posted May 8, 2010 If the mouth is full of brains makes it much easier to oxygenate the grey matter.... Dudley Re: Re: Airway Question > > So you're older are Ya bragging or complaining. > > Brand new as in NJ went to the 2nd Ed in mid 1981 so it could have > been 20 > years old it was new to us > > Also I think it was Brady or maybe a pre-Brady Publisher that in the same > year as that did a Basic book with a set of color plates that were > piloted > in some places in NJ same time. we got a look at that and were all a > gast at > the color, it was so novel. Again new to NJ in 1981. > > Louis N. Molino, Sr., CET > FF/NREMT-B/FSI/EMSI > Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant > > LNMolino@... > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds > discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > > In a message dated 5/6/2010 4:09:26 P.M. Central Daylight Time, > krin135@... writes: > > pardon, Sir, but the " Orange Book, Second Edition " was *at least* 6 years > old by the time you took your -A course. > > I took my 81 hour -A course in 1976-7 with the Second Edition... and, > IIRC, > we were the second or third class at that training center to use it (St > ph's Hospital Medical Center, Bloomington, IL). > > ck > > In a message dated 5/6/2010 16:03:43 Central Daylight Time, > _lnmolino@... _ > (mailto:lnmolino@... ) writes: > > Part of the issue here is the 6th edition is a full 4 editions ago. > > Granted even me a Basic knew that nasal intubation was a NO NO in the > case > of a skull fracture. > > Oh my EMT-A course in 1981 was with the brand new AAOS 2nd Ed. > > Louis N. Molino, Sr., CET > FF/NREMT-B/FSI/FF/N > Freelance Consultant/Trainer/Freelance Consultant/Trainer/ Freelance > > __LNMolino (AT) aol (DOT) _LN_ (mailto:_LNMolino@... > ) _ (mailto:_LNMolino@... > _ > (mailto:LNMolino@... ) ) > > (Cell Phone) > > " A Texan with a Jersey Attitude " > > " Great minds discuss ideas; Average minds discuss events; Small minds > discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) > > In a message dated 5/6/2010 3:28:09 P.M. Central Daylight Time, > __medic0946 (AT) yahoo (DOT) _me_ (mailto:_medic0946@... > ) _ > (mailto:_medic0946@... _ > (mailto:medic0946@... ) ) writes: > > Rick, you were correct. Nasal intubation should be avoided in the > possibility of basal skull fx. > > > > > > Ok group, > > I normally do more reading than talking on here, but I have a question > that is killing my brain, LoL. I'm studying for my NREMTP using the > " > Caroline's Emergency Care in the Streets 6th Edition " student workbook. > > > > Under the " Airway Management & Ventilation " chapter the question > states, > > > > You have a 42 y/o female extricated from a wrecked vehicle; she is > unconscious and has a depressed skull fracture at the back of her > head. To > secure an airway would you choose, > > > > A. Blind nasotracheal intubation as the preferred technique. > > B. Tracheal intubation as the preferred technique. > > C. Cricothyrotomy as the preferred technique. > > > > I chose " B' as my answer, and was told (by the answers in the back of > the book) that the correct answer was " A " . Please correct me if I'm wrong > as > I am still learning, but have we not always been taught NOT to use > nasotracheal intubation if the pt has a skull fracture of any kind? > > > > Everyones input will be greatly appreciated, because I really need to > pass my test. > > > > Thanks, > > R. > > > > Democracy will cease to exist when you take away from those who are > willing to work and give to those who are not. > > Jefferson > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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