Nurses and extubation - page 2

I would like to know if nurses or allowed to extubate patients without having the anesthesiologist around? Or if nurses have intubated patients without having and anesthesiologist around? Is a CRNA... Read More

  1. by   ethelbsnrn
    In the Philippines, we do not have RT's. We do the changing of vent settings, extubation, with the primary parameter - the O2 sat- reading, and of course the usual physical assessment thing.
  2. by   kyti
    We often extubate in the pacu,but it is at the direction of the anethesiologist or CRNA. When I worked in the ICU sometimes we extubated but usually the RT extubated under the direction of the pulmonologist or primary care Dr.
  3. by   athomas91
    there are of course nurses (flight) who are trained to intubate (that is a whole different subject)....i was primarily talking about extubation...i personally wouldn't want to do it as a nurse on the floor/icu/ED - i have seen what can happen - and i don't care HOW good of a nurse you are - if you aren't advanced trained in airways - you have nothing to save your butt when that pt crashes and the family lawyer goes for the jugular.
  4. by   duckboy20
    The hospital I come from physicians, anesthetists, or RT's can extubate or intubate. Nurses do not do so at all, unless they are ACLS and like everyone said, the only potentially qualified person around.
  5. by   NeuroICURN
    We extubate in our ICU all the time...and generally, the only other person I need is someone to shut off the vent when I pull the tube! LOL

    Seriously though...usually, our people are those that are on the vent for a while, so we too, have certain steps that we go through. Of course, there's also lots that we end up having to trach and peg.

    Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!
  6. by   Palpitations
    Yeah, I can back you up on that! I had one! Every damn time I tried to lay down to go to sleep, I'd have to get right back up to suction the darn thing! If it wasn't that, I was changing the dressing. It wasn't no fun at all!

    Melinda

    Quote from NeuroICURN
    We extubate in our ICU all the time...and generally, the only other person I need is someone to shut off the vent when I pull the tube! LOL

    Seriously though...usually, our people are those that are on the vent for a while, so we too, have certain steps that we go through. Of course, there's also lots that we end up having to trach and peg.

    Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!
  7. by   mattsmom81
    Quote from NeuroICURN
    Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!
    A stinky old one with copious spewing secretions ...and Lord knows what bugs in it (had one with GC once...uck) :uhoh21:
  8. by   Palpitations
    you took care of a patient that had gonorrhea in his/her trach? now, that is nasty! i'm sure that you went in the room with a face mask and gloves on! i know with my trach, when i coughed, i could shoot mucous across the room!

    i sure would hate to get a gc loogie blown on me!

    melinda
    Quote from mattsmom81
    a stinky old one with copious spewing secretions ...and lord knows what bugs in it (had one with gc once...uck) :uhoh21:
    Last edit by Palpitations on Apr 7, '04 : Reason: Fix the color
  9. by   CHIRN
    In general, a great majority of our patients like to extubate themselves. We just go with the flow.....
  10. by   NeuroICURN
    Quote from CHIRN
    In general, a great majority of our patients like to extubate themselves. We just go with the flow.....
    That's what restraints are for!!! The majority of our intubated patient's get restrained until they prove they won't extubate themselves.
  11. by   leslie :-D
    i was taught in school on how to give emergency tracheotomies. the example set forth was if you were in a restaurant and were unable to heimlich someone effectively, then you'd insert a sharp instrument inbetween the cricoid cartilage (i think 2nd-3rd) then insert a straw until emergency personnel got there.....now tell me that's not scary. does that cover us under the Good Samaritan Act?
  12. by   duckboy20
    Earle58- I would not even attempt to do so if I were you. You are definately not covered by the Good Samaritan Act. If you were to injure that person in any way you would be held legally responsible. The only thing you can do legally is the heimlich or CPR in that situation and wait for ambulance personnel.
  13. by   leslie :-D
    tell me about duckboy! i don't know why it was even taught to us but i don't think i've been in a restaurant since then.

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