EMS 20/20 Tough Crowd
Nov 10, 2021
A chaotic airway rescue unfolds amid a volatile crowd and equipment failures. Tension builds over whether to treat on-scene or rush to hospital. Repeated airway setbacks culminate in a surgical cricothyroidotomy. The conversation critiques agency policies, training gaps, and practical airway techniques.
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Inertia Of A Call Alters Clinical Decisions
- The inertia of a call can push crews to either rush transport or fix problems on scene, creating competing priorities between definitive care and immediate resuscitation.
- Grumpy and callers noted that stopping to work a code risks switching mindset to 'work it here' and delaying time-sensitive interventions like cath lab activation.
Prioritize SGA Use When System Limits Intubation
- Do favor supraglottic airways when your system prioritizes speed and has low intubation first-pass success, moving to ETT only when necessary and with appropriate sedation.
- Grumpy's service pushed iGel use and policy avoided paralytics, shaping airway choices and training emphasis.
Using A Bystander To Clear A Hostile Crowd
- Grumpy navigated a hostile crowd, recruited an elderly bystander to help clear access, then confirmed a pulse before rapidly moving the patient into the ambulance.
- This quick crowd‑management and delegation let them start assessments that otherwise were blocked on scene.