You aren't as good as you think

Ego. That is what you get when you get a room full of paramedics together. Needing CEUs, I was sitting in an advanced airway class today. During an in-class discussion, the subject of intubation came up, and I remarked that I often use airways like the King tube for intubation, because it allows a provider to manage the airway of a cardiac arrest victim without stopping chest compressions, and there is no worry about missed intubations. This increases survival rates.

A medic in the row in front of me said that he gets enough intubations that he isn't concerned about that, because he is confident in his abilities. He also told me that he performs RSI in his agency, and he feels like he is good enough that he doesn't usually bother to prepare a back up airway in the event that he cannot secure a tube. Later in the day, during a break, I asked him how many intubations he gets.
He replied, "Three or four."
I asked: "A month?"
He says, "No, a year."

How do you think that you are proficient in performing a very complex skill that takes 30 seconds, and that you perform once every three months? You are so confident that you will give a drug to a patient that makes it impossible for that patient to breathe on his own, without making sure that you have a back up plan in place, in the event that your primary attempt fails to secure the airway?

Later in the afternoon, we had the opportunity to intubate a METI man. (This is a computerized high fidelity mannikin that reacts to medical procedures like a human would.) This medic and his partner were given a scenario where the patient stopped breathing, and were expected to intubate the patient before he desaturated to the point where his heart began to malfunction.

They failed, because they spent over three minutes trying to intubate, and were not ventilating the patient. He blamed the other paramedic that he was partnered with for the failure.