It started with a post by Rogue Medic. One of the comments by an anonymous poster not only generated a reply post by RM, but then Ambulance Driver got into the act. After reading the posts and comments, I decided that I had to get in on this too. Originally, this was going to be a comment on AD’s post, but it became long enough that I decided to get some posting mileage out of it.
Anonymous is not only nasty, he’s wrong. Dead wrong. Only the dead are likely to be his patients or his systems patients.
As a soi disant profession working with and within another profession it’s our responsibility to put up or shut up. The studies from Los Angeles and other systems that demonstrated that paramedics (at least in their systems) were not competent at intubation were a challenge to EMS to prove them wrong. A few systems have taken up this challenge and proven that their system’s paramedics can intubate with a high degree of success and an extremely low degree of misadventure.
Other systems have taken the fingers in ears approach that AD outlines. They just know that their systems don’t have those problems. They don’t need no stinkin’ numbers, they have the certainty of faith to carry them through.
Even bad science will trump no science. Good EMS systems will need to respond with good science to refute the bad studies. It would also be beneficial if good systems could prove not only that their medics can intubate, but also identify the attributes that set the conditions for that success. It might turn out to be a low medic to ALS patient ratio, it might be something else. We won’t know until someone takes the time to find out.
Those who follow these things and participate in the various EMS forums have been hearing for several years now that it’s only a matter of time until most medics lose the ability to intubate. Most don’t believe it, but some do believe it and a few systems have even started to study the issue in a serious manner.
The problem is, that even in science it seems that hysteria and sensationalism often drive the debate.