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CAM - Crash Airway Management

When a person experiences head, neck or chest trauma, their airway often times becomes obstructed.

When working with a trauma victim whose airway is obstructed, E.M.S. training manager Michael Pcolar knows he only has a matter of minutes to save a life. "It's up to us to gain access to the airway and ventilate for that type of patient."

Paramedic Michael Hamel says that by sedating the patient reduces inner-cranial pressure, and relaxes the muscles giving E.M.S. access to the patient's airway. "The system that we are working with is Crash Airway Management."

Michael says that their program's name is "CRASH" because they have to perform it in a hurry. This is a highly advanced airway management system. "There's a five key procedure which entails: preparation, prediction of closed airway, pre-oxygen phase, positioning of the patient, and administering drugs to sedate and gain control of the patient."

Michael says that each case presents a new challenge, and his training is ongoing because he constantly learns new things. "Lee County E.M.S. is one of the five agencies around the U.S. using this group of medications, and we're very excited to provide this type of service."

Because Lee County E.M.S. knows the difference a few seconds can make in the survival of a trauma victim, they have trained all their paramedics in crash airway management.

Emergency Medical Services Magazine recently featured a story on these life saving heroes, and they have since gained national recognition.

I would like to know what everyone does for RSI and compare it to LEE COUNTY EMS in SW FL. They use a program called Crash Airway Management using Succycoline, Etomidate, and Propofol.
Lee County Emergency Medical Services in Fort Myers, Fla., implemented a Crash Airway Management (CAM) program in May. The program is part of an advanced practice curriculum aimed at improving conventional intubation success rates, predicting and managing difficult airway cases, introducing state-of-the-art pharmacy-assisted intubation agents, reviewing rescue/salvage airway concepts, and ultimately exceeding the standard of care in prehospital airway intervention.

The eight-hour class incorporates didactic and practical components: New and experienced paramedics are taught a "Five-P" approach to airway management—preparation, prediction, preoxygenation, positioning, and pharmacology. The new CAM procedures use the theory of premedication with Lidocaine and Atropine (for pediatrics), induction with etomidate and succinylcholine, and maintenance with Diprivan (intravenous infusions).

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