Inexperienced Paramedic Incorrectly Intubates Patient

ByVictoria Negron

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Updated onMay 22, 2018

Inexperienced Paramedic Incorrectly Intubates Patient

This case involves a middle-aged female with a history of diabetes who suffered cardiac arrest in her home. Emergency medical services arrived on the scene within 15 minutes and the decision was made to intubate the patient. The paramedic who intubated the patient was new to the team and had no prior experience intubating patients in the field. He accidentally intubated the patient esophageally and she expired in transport to the hospital.

Question(s) For Expert Witness

1. What is your experience intubating patients in the field?

2. What safeguards exist to mitigate the complications that occurred in this case?

Expert Witness Response E-117897

inline imageAs a paramedic, I use intubation as a means of securing the patient's airway. As part of continuing education, I complete an intubation skill-check every two years. I have completed or participated in a significant number of intubation procedures over my career in EMS. As a paramedic instructor, I have instructed students on intubation technique in mannequins and in live patients. The gold standard in verification of tube placement is watching and documenting the tube passing the vocal cords. Next, we would assess for chest rise and fall to indicate that the tube is in the trachea. Third, we would auscultate over the epigastrium for air going into the stomach. We would then auscultate the lung field to assess for the passage of air in and out of the lungs. We can also assess capnometry or pulse oximetry, however, that assumes that the conditions for cellular respiration and perfusion exist. The protocols under which the paramedic operated would list which assessment tools that were to be used to detect an esophageal intubation. At a minimum, the provider should have been monitoring heart rate, skin color, pulse oximetry, capnometry and assessing lung before and after each movement of the patient.

About the author

Victoria Negron

Victoria Negron

Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.

Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.

Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.

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