On today’s show, I talk with Craig Wylie an Emergency care Practitioner in Cape Town, South Africa.
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- Tell Me and I will Forget ( South African prehospital documentary)
- Tales from My Stethscope
- Paramedic Rapid Sequence Intubation (RSI) in a South African Emergency Medical Service (EMS) is effective, but is it safe?
- These are some preliminary communication notes between Craig and Yugan Pillay , another ECP doing prehospital research on RSI : 1. Reality check…RSI is an elective procedure i.e. the clinician makes a conscious decision to take away the patient’s ability to breathe 2. Training and availability of skilled RSI assistants (eg. ILS provider) is seriously lacking in SA 3. There is generally under-reporting of the presence of perceived difficult airways, especially in Trauma. This correlates to a risk of underestimating intubation difficulty. 4. More than 60% of ECPs believe that ALL ALS practitioners should be allowed to practice RSI, as long as adequate bridging training and mentorship is provided to CCAs and NDip practitioners5. Failed intubation is rare (less than 5%). There is concern however that reporting of failed intubations are inconsistent/inaccurate 6. Scene times must be viewed in terms of time-critical vs therapy-critical types of patients. 7. The use of mechanical ventilation has steadily improved since 2008 until now. 8. There is generally poor documentation of ventilation (Mode, rate, I:E ratio, waveform) 9. All PCR forms need to be standardized to include EtCO2 in the VITAL SIGNS block 10. A big concern is exposure of ECPs to the RSI procedure especially because there are so many more ECPs available now as compared to 5 years ago. Average RSI rate is less than 12 per year per ECP 11. Private does most of the RSIs. Government sector…there is more RSI activity in Gauteng and Western Cape. Minimal activity in KZN and other provinces 12. Private sector (big players) tends to be more proactive in managing risk surrounding RSI 13. prepackaged RSI kits are recommended 14. Infection control during RSI must be kept in mind!
Now, onto the PODCAST!
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