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Paramedic Intubation Consensus Statement

Posted: 11.09.2017

Comments: 5

Paramedic Intubation Consensus Statement

In May 2017 work began to write a position statement on Paramedic Intubation. Leading experts in this subject area within the profession were gathered to review all the current available evidence. This group met in July to discuss and to develop the first draft of the statement. This statement has since been reviewed and amended by several key clinical groups and is now released to the membership and wider Stakeholder organisations for comment. The consultation will run from 11th – 24th September 2017 with final publication in the British Paramedic Journal due in December 2017. Further review of this position statement will be carried out at such a time that additional relevant evidence becomes available. The College of Paramedics would like to encourage you to read this statement and to contribute to this consultation and the next stage in the review process by emailing any comments to consultation@collegeofparamedics.co.uk

Many thanks and on behalf of the working group, we look forward to receiving your comments. 

Liz Harris FCPara
Executive Officer

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Statement looks good and comprehensive. EtCo2 and an assistant must be mandated for all ETI if practice retained. No place for solo on scene intubators.
Personal view is limited number of specialists only. Good to see FO removal with Magills recognised as simple life saving still to be retained for all.

Good work all. Thanks for doing this

Added by: Richard.lee@wales.nhs.uk on: 11.09.2017

Concise and well put together report, adding to the many other reports on this subject.
My personal view is that Paramedics need this vital skill in their repertoire of advanced airway management adjuncts. The need for specialist paramedics such as HART Teams, Critical Care Paramedics, ECPs, UCPs etc, is justified in a range of different clinical settings and has proved successful, but more needs to be done within the urgent care arena.
With an estimated 30,000 out of hospital cardiac arrests treated by the NHS Ambulance Services a Year (http://bmjopen.bmj.com/content/5/10/e008736) and demand on the service rising year on year, getting the right response at the right time can be the difference between life and death,  a Paramedic on every vehicle trained and competent in intubation should be the minimum.
The definition of paramedic is “A person trained to give emergency medical care to people who are seriously ill with the aim of stabilizing them before they are taken to hospital”. (https://en.oxforddictionaries.com/definition/paramedic)
The unique and “in demand”! skill set of a Paramedic should not be diluted or thrown into confusion, but rather we should empower all Paramedics to continue to do the great work they do, delivering excellence in clinical care. Developing the profession, next stop Prescribing!

Added by: rocket on: 12.09.2017

A very useful document that offers concise guidance around the future of the intervention and how it should be delivered in practice.

Endorse it’s recommendations around ensuring clinicians involved in delivery of ETI are suitably drilled and have frequent exposure and experience.

Implementation of the documents recommendations will be challenging for a number of ambulance providers and it would be useful if the College could continue to support any changes with continued communications and leadership.

Added by: andy.swinburn@icloud.com on: 18.09.2017

A well written and concise document with some very valid points. Reference the comment 2 above about HART Paramedics having this skill, if it’d good enough for HART to have it is good enough for all Paramedics to have as most Paramedics would be on scene first before HART arrive as proven recently with the terror attacks, not only that in a multi-casualty incident there may not be enough HART paramedics for number of casualties.
As for whether paramedics should intubate or not i personally think they should, ETI is GOLD standard and as for SGA as good as they can be they don’t and won’t stop aspiration which as we know can lead to pneumonia. The mortality rate for aspiration pneumonia complicated by empyema is approximately 20%.
the documentation for most health providers would also be a logistical nightmare

Added by: Mal on: 18.09.2017

This is a concise and well written document for the future practice of Endotracheal Tube Intubation (ETI).

Personally, as a paramedic who works in a rural environment and involved in the recent Airway2 trial, I would not want to lose the skill of ETI.  Whilst there are other stepwise approaches to airway management, until the evidence from Airway2 has been systematically collated it is fundamentally the skill of ETI that gives gold standard protection to the patient’s airway. 

However, even-though it may not always be necessary to use an ETI and a SGA may suffice, for our profession to continue moving forwards the removal of ETI from our arsenal would be seen by many as a backwards step for Paramedics.

Added by: Piers Fuller on: 21.09.2017

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