Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!americast-post Newsgroups: americast.twt.metro From: americast-post@AmeriCast.Com Organization: American Cybercasting Approved: americast-post@AmeriCast.com Subject: Air aid updated with ET Date: Mon, 2 Nov 92 15:45:13 EST Message-ID: \SE B;METROPOLITAN \HD Air aid updated with ET \SH D.C. paramedics give breath of life \BY Matt Neufeld \CR THE WASHINGTON TIMES William McLaughin, a District paramedic, recently had a critically ill patient whose lungs were filling up with fluid - a potentially fatal predicament in which the victim can drown in body fluids because the oxygen supply is cut off. Mr. McLaughin needed to get oxygen into the lungs as soon as possible. In the District, up until just three months ago, city paramedics were essentially "at a loss" for ways of getting a large supply of oxygen into the lungs as quickly as possible, Mr. McLaughin, 44, said. But those days are gone. Now all of the District's approximately 110 paramedics have been trained in the use of a critical-care device medical experts call the "gold standard" of supplying oxygen and preventing cardiac arrest: endotracheal intubation (ET). ET, simply, involves pumping oxygen through a tube inserted down the throat into the trachea, which leads into the lungs. Although the system has been used in other major cities for years, it was not until the recent training was completed last week that ET was available to District paramedics. ET is used for patients in dire need of oxygen, such as those nearing cardiac arrest, with fluid building up in the lungs or suffering a major asthma attack. The system helped save William McLaughin's recent patient. Paramedics say the device has saved other lives as well in its first two months of use in the city. District paramedics have been waiting a long time to make such statements. "It's a great advantage. It's like being confined to a wheelchair and all of a sudden being able to walk," Mr. McLaughin said. "You know you're getting good air in. There's nothing like it. It's a great feeling to be able to do something like that." The first step of the ET system is to insert into the patient's throat a device called a laryngoscope, a smooth, short metal blade that pushes back the tongue and vocal chords, and, using an attached light, allows the paramedic to look down the throat to the opening of the lungs. In the next step, a lubricated plastic tube is inserted down the throat into the trachea. Next, a device called an ambu bag, a large bag that holds about 1 liter, is placed on the end of the tube outside the patient. The bag is filled with oxygen, and the paramedic then pumps the oxygen directly into the lungs via the tube. The process takes about 30 seconds. "It gives you a better avenue, a better control of the airwaves, a better mechanical measure to breathe for the patient," said Louis Carter, 41, a District paramedic since 1980. "It is better than the old, conventional ways. It gives you a direct line into the lungs." In the past, paramedics gave patients oxygen through a mask placed on the face, injected medicine and went to the hospital, hoping the patient could "hold on until a doctor in the hospital" could start ET, said Dr. Robert R. Bass, medical director of the District's Emergency Medical Services Bureau. The old system was not as effective as ET because the oxygen did not get to the lungs as quickly, Dr. Bass said. ET is "the gold standard," said Dr. Bass. "There's nothing that does it any better. It really does improve the odds of a patient being resuscitated." Each of the District's seven medic units will carry six or seven sizes of ET tubes for use on infants to adults. The tubes are disposable; the laryngoscopes are disinfected after each use. The system cost the District about $30,000, "but it's worth it," Dr. Bass said. "It's one of the interventions that paramedics do that really makes a difference." It is too early to cite statistics, Dr. Bass said, but he estimated ETs have been used about 60 times in the city since July. He expects them to be used 80 to 100 times each month. "I think it can really help, especially these trauma cases - young kids who have been shot," said Mr. Carter. "If they're revived, they can have a second chance in life. And that's really important right now." This article is copyright 1992 The Washington Times. Redistribution to other sites is not permitted except by arrangement with American Cybercasting Corporation. For more information, send-email to usa@AmeriCast.COM