From my experience if a patient codes long enough or often enough they always end up with bleeds somewhere.
We take up the majority of all OHCA's in our area and we see our share of traumatic intubations. I also see my share of fingers pointed at the prehospital care teams (in Belgium OHCA's are attended to by a ER nurse and ER doc from the hospital), but I like to start with the assumption they are capable at what they do. In the end that's the type of attitude I expect from others when they come into my ICU to respect and acknowledge my expertise in that area.
Generally these traumatic intubation bleeds are self limiting and rarely have I seen gross amounts of blood being evacuated. What we see much more often during extended codes is diffuse pulmonary bleeding. When it finally seems we are getting the patient under control the ETT starts filling up with blood and there we go again
In the end we musn't forget that even a little blood mixed with saliva for example will look like a massive amount of blood. It could be just something simple like that.
Last edit by BelgianRN on Jan 19, '12
: Reason: typo