Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

The Real Gold Standard Of Airway Management at 510Medic


510Medic has a nice post about The Real Gold Standard Of Airway Management.

The way he started out, I expected a riff on Nixon taking us off the Gold Standard – $35 an ounce due to price control then – now just under $1,300 an ounce. Last week, there was this – Gold Bet: $2500 Over/Under 2012. Even I am not cynical enough to take the over on that.

The Gold Standard 510Medic is writing about should be just as dead as the monetary gold standard.

There are some similarities. Both are inflexible and artificial limitations on change.

The idea that intubation is a gold standard only demonstrates an inability to adapt to what is best for the patient.

The gold standard is supposed to mean what is best for the patient, but does it?

In the emergency department, cardiac arrest patients are only intubated in the old fashioned Bretton Woods style of treatment. I expect the new guidelines to continue to de-emphasize intubation as a method of airway management.

In the operating room, intubation has become much less common.

If the emergency physicians and anesthesiologists are switching to more appropriate airway management methods, why isn’t EMS?

Because we are EMS. It sometimes seems as if you have to kick us in the head to get us to use our heads for anything.

As with helicopter abuse, we are not doing what is best for patients.

As with restrictive protocols, we are not doing what is best for patients.

As with on line medical command permission requirements, we are not doing what is best for patients.

As with cardiac arrest drugs, we are not doing what is best for patients.

As with spinal immobilization, we are not doing what is best for patients.

As with restrictions on prehospital pain management, we are not doing what is best for patients.

Are we surprised that, when it comes to airway management, we are not doing what is best for patients?

Let’s put an end to the Gold Standard terminology.

Airway management is about Ventilation – not Intubation.

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