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Today's Paramedic quote:
Blood goes round and round; air goes in and out; any variation from this is bad. - Paramedic 101.
Paramedics should start to consider intubation for any patient who is no longer effectively managing their own airway. Paramedics should be hesitant to wait until a person is completely unconscious before that start to think about intubation and getting equipement ready to intubate.
All patients with the following medical conditions should be intubated:
1. Patients who have suffered a cardiac arrest
2. Patients who have severe maxilla/facial trauma
3. Burns patients who have suffered burns to the upper airway
4. All severe cases of hypoxia in which the paramedic is unable to maintain adequate oxygenation through any other means (such as bagvalve mask ventilation and intermittent positive preassure ventilation (IPPV).
5. Persons with a traumatic or non-traumatic brain injury that become combative and are safer once sedated and intubated.
6. Drug overdoses, unresponsive to naloxone or flumazenil, such as GBH overdoses, in which the patient has intermittent periods of consciousness and complete unconsciousness.
Intubation should be performed as a last resort, but this does not mean that planning and preparation for intubation should wait until the last minute!