Should Paramedics Be Allowed To Intubate?

For those of you who demonize Dr. Henry Wang for his medical studies critical of the ability of paramedics to safely perform endotracheal intubation, read the panel discussion on JEMS.

As you can see, the man is a proponent of allowing paramedics to continue using the procedure, as are all of the other panelists. They all agree, however, that we need to get better at it, and utilize it more appropriately. If we don’t, we’re likely to see this skill either removed from our skill set, or limited to a few very highly trained paramedics.

A good first step would be debunking the myth that endotracheal intubation is the gold standard of airway management. Optimal airway management is gauged by a desirable outcome – adequate oxygenation and ventilation – and not a particular piece of equipment. If your greenest EMT-B Newbie can sustain his patient’s adequate oxygenation and ventilation with nothing more than an oropharyngeal airway and positioning, then he has achieved the gold standard of airway management.

Airway management is a continuum of care, people.

Once the majority of paramedics abandon the notion that our talleywhacker size somehow corresponds to our willingness to use a laryngoscope, we might actually be able to take the steps necessary to get better at it.