RSI, who does it?

[Romania]

Are there any states that allow medics to carry RSI meds and perform RSI? There is talk here in AZ, has been for a while, about finially letting us do it. Currently only flight nurses have tha capiblity in the field.

For those of you who can do it, what are the pros and cons?

Thanks

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Alan Romania, CEP
romania@uswest.net
IAFF Local 3449

My Opinions do not reflect the opnions of the IAFF or Local 3449.

[BURNSEMS]

Howdy,, Our Private EMS Provider carries RSI drugs and has protocols for the procedure on Head Trauma Pts ect, BUT I cant figure why they call it RAPID because it is realy not if you take into account for all the steps you have to carry out, While I was in Medic School we had the opportunity to do one in Med Surg it was real neat but those folks do it several times a month not once a year.. as with any thing I question Skills retention,we can Do I.O.s but I havent done one other than skills check off in Medic School I would be pretty slow I am sure, its been over a year... Our Provider has done it a Few Times during MVAs ect and its way better then Letting Them Struggle and Fight but the Drug only Last a Few minuets and you have to be ready for the Paralazation and most times the Patient may be Conscious, and you better get the Tube the First Shot, I understand the Drugs are expensive and there are some contridications to there use. I think its a great Skill for Paramedics to have BUT Keeping the skills up might prove challenging if you dont have a aggressive Med Control, Training Dept.... Just My Opinion

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Here today for a Safer Tomorrow

[Boothby]

Seattle does it. So do alot of small departments in washington state. We are allowed to do it by state regs, but our medical director has teeny tinny testicles and won't give us permission.

[Aff]

Lakeview Hospital's paramedics are allowed to perform this upon completion of training. Lakeview Hospital is in Stillwater, MN. and provides ALS services to many of the eastern suburbs of St. Paul. Their Medical control is Regions Hospital in St. Paul. Although I am not 100% sure , I believe St. Paul fire, IAFF 21, also performs this proceedure.

Mark

[Romania]

To continue this, my read on RSI is that it is a very effective tool if your airway skills are good. It is called Rapid because it is quicker than waiting for a patient to become unc. I have attempted (with moderate sucsess) to nasally intubate patients who were good candiates for RSI. What are your guy's feelings on RSI. Should medics be aloud to perfom it of not?

Thanks again

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Alan Romania, CEP
romania@uswest.net
IAFF Local 3449

My Opinions do not reflect the opnions of the IAFF or Local 3449.

[Aff]

Yes, a skilled and trianed ALS provider should be allowed to perform this proceedure. A patent airway is life.

Stay Safe...
Mark

[BURNSEMS]

ABSOLUTLY

[Boothby]

YES, YES, YES. Nasal trachial intubation is a good option, but if the patient is concious they will rarely tollerate it. I'm talking about acute CHF patients who need to be tubed now. I've only had one guy who let me pass the tube. As for trauma I have had a couple of patients who would have been good candidates ie decreased LOC and jaws clamped shut. Again you always have the nasal route, but there is controversy over nasaly intubating head trauma. I have seen some very interesting research that indicated that there are no documented cases of cranial vault penetrations through nasal intubation... but thats another topic. RSI should be included in your bag of airway management tricks.

[Matt Trotta]

North Carolina allows RSI and I know that Gaston county utilises this skill. In Union county we do Nasotrachel Intubations using the softer 'Trigger tube' ET tubes. The Doc that gave us our training on these stated that if you had a crainal floor defect that the tube would penetrate your Pt. is not viable anyway

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Matt Trotta EMT-Paramedic