learning to intubate - Page 2

I am not a CRNA, only a flight rn--but we intubate peds and preterm babies.

I completely understand your woes. It usually takes me several looks--but I am pretty new at it.

You can not imagine how small the airway of a 25 week (gestation) preterm baby is---- it is a "white knuckle experience".

cb

I have complete respect for paramedics & flight nurses it is bad enough trying to intubate under controlled circumstances. I don't even want to try to intubate someone outside of the hospital at this point....and I can't even imagine trying to intubate someone in moving vehicle!

All the former RNs who were former medics appreciate the acknowledgement.

Intubating in a controlled environment like the OR can present enough challenges... without the stress of having to intubate a patient in cardiac arrest who is wedged between their bed and the wall (with poor lighting of course and aspiration of course) which just adds another unwanted variable to an intubation scenario.

In anesthesia school they almost always teach you with the MAC starting out. After my first three months in I switched to the Miller and have never looked back. I personally feel like it takes much less lifting and straining, which I see a lot of Doc's and CRNA's doing with the MAC blade. There are only three instances where I use a MAC blade and they are as follows: 1. Double lumen tube insertion, 2. Blood in the airway, 3. Large tongues that I feel will slip off the that little straight blade.

Securing an airway should never look like a struggle. It should be SMOOTH, quick and with confidence. After a few hundred you will get to this point. Now I'm not saying I don't have difficult airways come into my operating room but if I can't get it with my trusty Miller I sure as heck don't go to the MAC, I go straight fiberoptic.

My advice, alternate each case ---Miller--Mac--Miller--Mac---etc

Get proficient with both blades and use alternative methods to intubate. Don't let your first time with a blade or device be under emergent conditions.

"Watch one, do one, kill one, bill one." Repeat until learning takes place.

Not funny....