The Roles of Physicians and Paramedics in Airway Management Techniques in Prehospital Care

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  • 気管支領域におけるプレ・ホスピタルケア : 医師と救急隊員の役割

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Abstract

The Emargency Medical Personnel Law was approved last April. With this law it became possible for emergency medical technicians (EMTs), to give medical treatments once they obtain state qualification otherwise knwn as paramedics. Emergency tracheal intubation by the paramedics, however, is controversial. Examining the report on fire service in Japan in 1989 and other materials, the estimated number of cases in which intubation was necessary war 211, 791 and we could expect a 19.6% increase in survival rate. 81.8% of physicians to whom questionnaire was sent agreed to intubation by paramedics. The University of Washington School of Medicine offers the longest paramedic training program course in the world. In their 2, 500-hour program, lectures on intubation only take up 22 hours including practice on a mannequin. During field work, emergency room experience and internship, students performed 30∿40 actual intubations. After certification each paramedic is required to perform a minimum of 12 field endotracheal intubations. Even with this rather limited experiences no serious complication has been reported. From the above results it seems possible for paramedics to perform emergency endotracheal intubation in our country.

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