True, but pretty rare...
...true...
...false.
Okay, I can bag the patient who's bleeding or vomiting into their airway, but its not going to be effective, either because I have to suction all the time due to bleeding or vomit or because the patient is aspirating vomitus that's made its way around the adjunct. Vomit, if its not passive or if its in copius amounts, can get around the balloon on the distal end of a combi or king tube, and I'm pretty sure it could get around an LMA too. Squeezing a bag and getting poor compliance is not effective ventilation.
Intubation isn't just about sticking a tube in someone's throat so that they can breath, its about protecting the lower airway.
-e-
Maybe you missed the part of my point where I said that you should drop alternative airways if you're not able to intubate. I'm not saying we should sit around and let every Medic on scene try and drop the tube, but you should give your best guy at least 1 shot if not two at it, if your situation allows for it. But I can't stress it enough, you've got give the patient some kind of patent airway and an ET tube
is the best at providing a patent airway and if you can drop it, you should.
-e2-
I don't think we really disagree, I think it might have just been my wording or your interpretation of it. I'm really aggressive with airway management and the system I'm training in have enough hands on scene that we can put 2 people on just airway management. I think we can both agree that mortality and morbidity are substantially reduced if we can prevent the aspiration of fluids,
especially vomit into the lungs and that providing the patient with
some form of secured airway should be a top priority.