Intubation, a life-saving intervention where a breathing tube is inserted into a patient’s airway, has been the gold standard for treatment of airway emergencies for years. Late last year, for patients under 15 years of age, this procedure was deleted from treatment protocols for paramedics operating within SanBernardino, Inyo and Mono Counties.
Why is this a concern?
San Bernardino is geographically the largest county in the lower 48 states, covering 20,105 square miles, while Inyo and Mono counties together cover nearly 15,000 more. In remote areas, patients may be located up to an hour or so from the nearest emergency department. In the types of cases where intubation is indicated, failure to secure a patient’s airway may lead to brain injury within minutes, especially for children.
Removing this skill from a paramedic’s skill set reduces options for securing a child’s airway when it is needed most. There are other options for airway management, and they can be effective, but intubation provides the most direct route for getting oxygen into a patient’s lungs. Basic airway procedures often provide diminishing returns on the long transports experienced this part of the state, even when performed expertly.
Meanwhile, intubation remains in place as an approved procedure for adult patients.
Inland Counties Emergency Medical Agency or #ICEMA, the governing body for EMTs and paramedics across the three counties, is concerned that intubation, when performed incorrectly, can cause damage; this is what led to removing the protocol. However, paramedics are highly trained in this procedure. In fact, the learning of, and continued training on, the skill of intubation is a major hallmark of a paramedic’s education and career.
New equipment and technology now available to paramedics can reduce some of the risk of pediatric intubation. #Local935 supports the reintroduction of this skill for our youngest, most vulnerable patients.