A tracheostomy opens a direct airway into the neck. Its prevalence in long-term care is increasing, and some providers assert that early tracheostomy in mechanically ventilated patients may decrease complications and reduce morbidity. In the emergency setting, a tracheostomy can save lives when other airway management strategies fail. Like all medical procedures, a tracheostomy presents specific advantages and disadvantages. Here’s what you need to know to make a decision. 

Both basic and advanced airway management can save lives. Neither is more important than the other. Nor is one the “better” option. Indeed, when basic airway management is the safest and most effective option, immediately escalating to advanced airway management can be immensely harmful. 

Airway management is a key pillar of emergency medicine. When performed correctly, it can save lives, improve surgical outcomes, and improve quality of life for terminally ill patients. However, airway management presents a number of complications and risks. Knowing the contraindications for airway management can help you better serve patients and reduce the risk of needless morbidity. 

Assessing for a gag reflex is a basic skill that can become important in a variety of medical settings. It is also a way to measure brain death. Medical experts, however, now caution against using the gag reflex as a primary determinant of whether to intubate, or as a measure of airway health. So first responders must balance competing information and studies to make informed decisions in each individual case. Here’s what you need to know about checking for a gag reflex in an intubated patient. 

Prehospital care is about much more than just stabilizing patients and moving them on to the next step. The decisions you make can have far-reaching implications for a patient’s life and well-being. This is why it’s so important to gather as much information as possible, and to act collaboratively with family members. Include them in the decision-making process as much as you can, and remember that the patient has final say over their treatment. 

Life as a paramedic means intense highs when you save lives and tend to grateful patients, as well as bottomless lows when patients die, suffer, or become combative and angry. You’ll need to be prepared for the sudden adrenaline rush of a patient in need, as well as the slow and methodical approach that intubation, explaining procedures to patients, and gaining the trust of seniors and children all demand. Paramedic jobs consistently top lists of the most stressful professions. Over time, this stress can affect both your physical and mental health. 

It’s a dramatic plot twist in movies, medical dramas, and even the occasional sitcom: a character is choking or in respiratory distress and standard interventions like the Heimlich maneuver just aren’t cutting it. So a heroic bystander takes things into their own hands and jams a pen into the victim’s throat, much to everyone’s horror. But then, to everyone’s shock and relief, doing so clears the airway, allowing the survivor to breathe until help arrives. But can you really do this?