- © 2004 Canadian Medical Association or its licensors
Unfortunately, I cannot agree with Richard Verbeek and associates1 that paramedics should not intubate patients with SARS-like symptoms in the prehospital setting. If we applied their logic to certain other clinical scenarios, paramedics would never, for example, insert an intravenous line for fear of contracting HIV infection. A reliable history of HIV risk factors is difficult to obtain in the field, and the uncontrolled circumstances in which paramedics work increase the risk of needle-stick injury. If the rule is that no risk to the provider is acceptable, regardless of the benefit to the patient, very few interventions in the field would be possible.
In fact, the greatest life-threatening occupational hazard for paramedics is trauma from motor vehicle crashes. If the approach suggested by Verbeek and associates were extended to transportation risks, paramedics would never exceed posted speed limits, would never proceed through a red light and might not venture out on a dark, snowy night at all.
The authors' analysis does a disservice to the brave men and women, dedicated professionals all, that I have encountered in this discipline.
Howard J. Ovens Physician Mount Sinai Hospital Toronto, Ont.
Reference
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