Airway management includes reporting unsafe practices

Procedures/devices that ensure an open pathway for gas exchange between a patient's lungs and the atmosphere

This is the second of 10 articles in the 2017 EMSFORWARD campaign. Read the article announcing the series or visit to access the full report and additional patient safety resources.

"Pre-hospital airway management is a key component of emergency responders and remains an important task of Emergency Medical Service (EMS) systems worldwide."

Jacobs & Grabinsky. "Advances in pre-hospital airway management." International Journal of Critical Illness & Injury Science, 2014

Scenario: An EMS crew, which includes a new paramedic, responds to a call of a patient in respiratory distress. Upon arrival, the patient is struggling to breathe and in severe distress. The crew proceeds to perform a rapid sequence intubation. They confirmed the tube placement with fogging of tube and breath sounds. The patient is then loaded into the ambulance.

Courtesy photo

Once in the ambulance, the new paramedic notices capnography equipment in the vehicle, but sees the more experienced crew members do not utilize it. He doesn’t say anything. He is still new and assumes the senior paramedics are following the protocol as they see appropriate. However, he feels strongly they should be using the equipment and is now worried about the patient.

Ask yourself: Do you have a culture where providers will speak up if there is something unsafe?

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