In that case I take it back - to a degree; we know they are sometimes contributory factors. However, the fact I think you made the right decision still stands. It is unreasonable to expect a Paramedic to perform an intervention they have probably never done before in 3, 4 , 5, maybe more, years. There should be regular training for this; especially if the Service deemed it so important as an intervention. The reality is most people are not going to keep paying for courses to refresh on a procedure they hardly ever perform. So with both those in mind, diesel seems like the most appropiate measure most times.