If We Were Really Serious About Intubation Quality – we would require that each medic be intubated by a different medic at least once a month.
This would get rid of all of the whining about a lack of opportunity to get any live practice.
We would quickly learn who can intubate.
Medics would develop an interest in outcomes that are longer term than just dropping a body off at the ED (Emergency Department).
Each month every medic gets at least one tube – or no tubes.
We get to listen to some Ludwig van while letting our droogies show their stuff.
If you cannot convince any medic to let you attempt to intubate them, then you are prohibited from attempting to intubate any patient for any reason. This will quickly lead to more accurate peer assessment of quality.
You cannot attempt to intubate the same medic in the same year, unless there are fewer than 13 medics in your organization. This means that you can’t just end up with the easiest tube each month.
You cannot have the same medic attempt to intubate you in the same year, unless there are fewer than 13 medics in your organization.
You must also be on the receiving end of an intubation attempt or you are prohibited from attempting to intubate any patient for any reason.
If you cannot convince any of your fellow medics to allow you to attempt to intubate them, do we need to know anything more about how pathetic you are at intubation?
If no medic will allow you to attempt to intubate them, is there any good reason to allow you to harm patients by attempting to intubate the patients?
But . . but . . . but . . . what about infection?
Is there any better way to teach sterile technique?
But . . but . . . but . . . what about irritation?
Is there a better way to get medics to realize that we should lubricate the tube?
But . . but . . . but . . . what about injury?
Is there any better way to teach that intubation is supposed to be gentle?
But . . but . . . but . . . what about . . . ?
What about growing a set and learning to manage an airway?
We also need to make sure that our coworkers know how to manage an airway.
If the complication rate is too high when paramedics attempt to intubate other healthy paramedics in a controlled setting, why should we permit paramedics to attempt to intubate sick people in uncontrolled settings?
Most important may be the last part – you will be hooked up to a vent for 10 minutes after being moved from one stretcher to another.
And you will be heavily sedated, so you will not be assisting the tube into the right place, and you will not be able to let anyone know if your CO2 level is climbing rapidly due to a misplaced/dislodged tube.
What is unreasonable is the pathetic way we assess the quality of airway management in EMS.
Do you really trust the intubation skills of your coworkers?
Are you willing to prove it?
We would rather whine about how it is unfair to take away intubation.
We do not deserve to intubate.
Our patients do not deserve to be abused by us.