@armyemdoc An old anesthesiologist attending said he wouldn’t completely trust anyone alone with an airway until 500 DLs. Emergency airways is a different animal and I���d want at least 500+ regular o’ intubations prior to wanting to be alone with a true emergency airway.

@dr4kujayhawks1 I doubt most EM residents are getting anywhere close to 500 tubes

@armyemdoc Query. Once proficiency previously achieved but you’re at the stage of your career where you are rarely the actual intubator, do you forget or is it like riding a bike?

@eoconor209 That was not a part of this study

@armyemdoc I don’t think you experience a sufficient amount of difficult airways with this number. Maybe you can successfully intubate a normal emergency airway but good luck with a difficult one…

@MusstduD It helps if you actually read the paper cited

@armyemdoc This is the best argument ever for DGH EM doctors to NEVER do an intubation. 50 intubations is probably a year’s worth in my department, so there is no way 10 consultants and a dozen senior registrars could achieve this in 20 years.

@MattHeywood1974 It helps if you read the paper before commenting. It included intensivists and anesthesiologists.

@armyemdoc And that's a lot on one patient! Ba-da-bum!

@armyemdoc Interestingly, ENT surgeons have significantly less intubation experience but are oftentimes called to assist in difficult or failed intubation. We don’t cric or awake trach everyone either Explain that?

@armyemdoc Interestingly, I had a threshold of 100 in mind. However, the further I progress along the pathway, the more I believe that true mastery lies in airway strategy and management rather than technique !

@armyemdoc Can’t get my VPN to library to connect to be able to read the whole article but I can believe. The harder part is maintaining. Back in ‘82 as a medic I did exactly 365 intubations, oral, nasal, a few cric. When I’m quit prehospital of all types 25 years ago I think I did 12,

@armyemdoc @aditya_gan3500 Please check this

@armyemdoc 500-1000 emergent and non emergent intubations to be secure with pretty any kind of airway.

@armyemdoc

@armyemdoc @jfletchermd All my intubations are emergency intubations.

@armyemdoc Without a doubt. It is a seldom used skill, depending on your environment, and can kill people with the slightest error.

@armyemdoc My count 5

@armyemdoc In his paper on ETI in the ED, Graham CA. Advanced airway management in the emergency department: what are the training and skills maintenance needs for UK emergency physicians? Emerg Med J 2004;21:14-19 - here is the link: https://t.co/Inw8IwcabR felt the number was around 80.

@armyemdoc I’ve done to many I’ve switched to left handed for a challenge.

@armyemdoc I learned this in paramedic school in 2010. Insane. Our medics do pretty good than

@armyemdoc This is a new paramedic using 3 different laryngoscopes in a SALAD simulation In studies evaluating the Vie Scope, ALL users were novice & they compared the VS to laryngoscopes that they had used for years. Results show for difficult airway, its superior to DL & equivalent to VL

@armyemdoc @LlorensPere As the result, no emergency physisian has to do intubations? Should we always wait for ICU?