Why Do You..... Q&A w/ Jeff Jarvis

Why Do You…

Williamson County EMS takes airway management seriously. We’ve learned the hard way that sometimes things don’t go the way we want them to. To avoid this, we’ve looked at every part of our airway management process, evaluating each step for ways to improve it. We do this by looking and collecting data on what works and what doesn’t work. We’ve published some of these efforts: We only use the King Video hyper-acute channeled laryngoscope1(there are no DL devices on our trucks) and we do not intubate hypoxic non-arrest patients.2We recently published an expanded discussion of the physiology and research behind our approach to avoiding peri-intubation hypoxia. Unfortunately, those papers don’t have the space to answer some of the more common questions about “why” we do some of these things. So, here is my rationale for why we do what we do. I’d greatly appreciate it if you read my reasoning before firing off the “I’ll stop intubating hypoxic patients when you pry my DL from my cold, dead fingers” tweet.

Why don’t we intubate hypoxic patients? Ever?

Wedo not intubate patients for whom we can’t achieve adequate pre-oxygenation despite our best efforts. So