Biomedical subjects

T Hatley

Publications and source records attributed to T Hatley.

2 recordsLinked to original sources

PubMed1998

Intubation success rates improve for an air medical program after implementing the use of neuromuscular blocking agents.

To determine whether the success rate for endotracheal intubation improves after implementing the use of neuromuscular blocking (NMB) agents in an air medical program, this retrospective study analyzed all patients requiring endotracheal intubation at two air medical programs (nurse/paramedic crews) over a 5-year period. Air medical program A, the control group, had employed NMB agents throughout the entire study period. Air medical program B, which did not use NMB agents from July 1, 1989 through June 30, 1992, implemented their use starting July 1, 1992. For program A, the overall intubation success rate was 93.5% (202 successful intubations in 216 patients) and the successful intubations/total attempts ratio was 0.67 (202 of 301). For program B, the overall intubation success rate improved from 66.7% (46 successful intubations in 69 patients) before NMB agent use to 90.5% (57 in 63) after NMB agent use (P = .001). The successful intubations/total attempts ratio increased from 0.36 (51 of 141) prior to NMB agent use to 0.48 (63 of 132) after NMB agent use (P = NS). In comparing the 92 patients who did not receive NMB agents to the 40 patients who did, the intubation success rate increased from 69.6% (64 of 92) to 97.5% (39 of 40) (P < .001) and the successful intubation/total attempts ratio increased from 0.36 (73 of 202) to 0.58 (41 of 71) (P = .007). With the use of NMB agents, program B's overall intubation success rate increased significantly, matching the results of program A.

Adjuvants, Anesthesia↗

PubMedDate not supplied

Flight paramedic scope of practice: current level and breadth.

This study's objective was to determine the current level and breadth of flight paramedic scope of practice. A six-item survey of lead flight paramedics in 158 air medical programs addressed five issues: 1) Certifications required above state certification; 2) Procedures included in scope of practice; 3) Medications flight paramedics are allowed to administer; 4) Requirements needed to expand scope of practice; and 5) Views on establishing a National Flight Paramedic Certification to alter their scope of practice. Eighty programs out of the 90 respondents (89%) stated that they utilize flight paramedics. Of these 80 programs that use flight paramedics, 76 programs (95%) require certification in ACLS, 65 (81%) in PALS, and 50 (63%) in BCLS. Paramedics are allowed to perform cricothyroidotomy in 68 programs (85%), pericardiocentesis in 24 (30%), and tube thoracostomy in 23 (29%). Medications approved for administration include streptokinase in 37 programs (46 %), r-TPA in 48 (60%), and succinylcholine in 50 (63%). In 61 programs (76%), the scope of practice is determined solely by the air medical director. Eighteen respondents (23%) believe that the development of a National Flight Paramedic Certification Program would alter their scope of practice. In conclusion, flight paramedic scope of practice varies enormously. Since most medical directors have the authority to alter flight paramedic scope of practice and few programs believe that a National Flight Paramedic Certification would alter their practice, medical directors should work directly with flight paramedics to expand their scope of practice.

Air Ambulances↗