....ok, now this thing is on a roll...
A great case report in the EMJ from HEMS (Helicopter Emergency Medical Services) in London, UK.
Cyclist vs van. Severe face and head injuries. Great passers by kept him on his side so he could maintain an airway, the (BLS) paramedics did the same, keeping his airway drained. HEMS arrive with ALS paramedic and physician on board.
Intubation is predicted to be difficult. Patient is not tolerating the mask (getting agitated), so he is difficult to pre-oxygenate. So they sedate and analgese him with ketamine.....he tolerates the mask....is as pre-oxygenated as possible....they keep him on his side until they are at the point of passing the ET tube.
A description of great teamwork, great pre-hospital care and how common sense and basic airway techniqes kept him alive......then followed by 'sedation to allow oxygenation' prior to (?D)SI