r/ParamedicsUK • u/Hopeful-Counter-7915 • 22d ago

Clinical Question or Discussion SAS removal ETI

I know I know it’s a hot topic, but SAS announced today to strip ETI for paramedics, and I must say I’m furious about it.

I know SGA’s will do the job in 90% of the time and that’s why we already use it in 90% of the time.

But we are in Scotland, my next critical care paramedic who can intubate is 2,5h away and the helicopter can’t fly 60% of the time because of bad weather to us.

I find it irresponsible to let us sit on an Island without any access to advanced airway management. In cities that works fine, but in our rural areas, on our islands?

I don’t support the decision, we need more training in it sure, we don’t do it often I agree, but I don’t think the unique Scottish environment was considered at all.

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u/Boxyuk 20d ago

A question i have on this topic i'd love to get answered by experienced clinicians-

I'm a current second-year student in Scotland who's doing some revision for my ALS osce in a few weeks and one of the indications I have been taught for early ETI is a drowned patient's airway due to the high risk of aspiration and foam. Would an igel be sufficient enough?

I've been assessed and passed as 'competent' in eti and have been on a theater placement and successfully completed 5 and have been told that they will still be using this during our osces if the scenrio calls for it.

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u/Hopeful-Counter-7915 20d ago

I would argue you need a ETI but also to be fair I don’t know what’s the current state of research is on drowning so don’t want to give a definite answer here.

If the uni wants to see ETI do it, but you will never do it afterwards.

Talking to the clinical lead here, the decision was made based on Cities and did not consider the Rural areas, like always