what would you do!!!!

[sweetnurse63, BSN, RN]

I was recently looking at a tv show portraying a nurse working in triage ER and the patient had coded in which he needed to be intubated ASAP. The doctor who was an intern could not do it, she actually froze; meanwhile, patient 02 sat is steadily dropping and the nurse intubated the patient to save his life. The regular physician came in the room screaming at the nurse because she was out of her scope of practice which is true, but if she had not:confused: did what she did the patient would have died. Do anyone know of any real life situations like this?

[ChristineN, BSN, RN]

I have never been in such a situation. However if the nurse had been trained in intubation in training as a SRNA or a paramedic I would not have an ethical problem with it.

[Whispera, MSN, RN]

The situation presented by the television show led viewers to think the option was intubation or death. What about CPR? New guidelines for CPR are Circulation, Airway, Breathing, in that order, so CPR with chest compressions would come first, while someone yelled for help.

I think if the situation happened as the tv show portrayed, depending on how the nurse's employer reacted, she could either be in big trouble or be counseled to not do it again, with everyone understanding it's the only thing she could have done at the time, given the choice between doing it and having the patient die. I think the fact that it happened in the ER rather than out in the community could be seen as a deal-breaker too. In the ER, there were probably other people around who could intubate, while there wouldn't be such people out in the community.

Even so, guidelines are C, then A, then B...

[sweetnurse63, BSN, RN]

The situation presented by the television show led viewers to think the option was intubation or death. What about CPR? New guidelines for CPR are Circulation, Airway, Breathing, in that order, so CPR with chest compressions would come first, while someone yelled for help.

I think if the situation happened as the tv show portrayed, depending on how the nurse's employer reacted, she could either be in big trouble or be counseled to not do it again, with everyone understanding it's the only thing she could have done at the time, given the choice between doing it and having the patient die. I think the fact that it happened in the ER rather than out in the community could be seen as a deal-breaker too. In the ER, there were probably other people around who could intubate, while there wouldn't be such people out in the community.

Even so, guidelines are C, then A, then B...

I agree with you whispera because they did not show CPR at all

[RoyalPrince]

The nurse should not have intubated the patient. The stupid intern should have ran and got the Attending while ordering the nurse to begin CAB

[noahsmama]

Real life ERs have ambu-bags too, so the nurse could have used that for the breathing part of the CPR.

[79Tango]

Ive witnessed this first hand. We had a PA straight up say "I do not intubate, I told them this when they hired me, someone needs to hurry!" She called the MD who brought RN to perform the procedure.

[SeeTheMoon]

Student here, and along these same lines I've been wondering if ACLS cert trains a nurse for intubation?

[tewdles, RN]

Nurses can intubate...depends upon their training and their place of employment. I have intubated many neonates and children in my career.

[elthia]

Personally, I've answered a code blue alarm, found a doctor leaning over a pt, " stating we need to bag him". I asked if there was a pulse, got no answer but " we need to bag him", found no pulse myself. Shoved the doc out of the way, grabbed the headboard off the bed, threw it under the pt, and started compressions.

Doctors seem to fixate on the airway...I have no earthly idea why...I'm all about the compressions, sometimes I get so much into it I forget to stop for the breaths if the pt isn't intubated.:uhoh21: Luckily my coworkers always remind me when it's time to breath, kind of like STOP FOREST..

[Double-Helix, BSN, RN]

The choices are very, very rarely only inbutation or death. Patients are intubated when they are not able to sufficiently breathe on their own. However, as long as the airway isn't compromised by swelling (in which case intubation might not even be successful), the patient can usually be maintained for awhile by bagging and compressions.

Since this was TV, of course they had to make it seem like there was no choice and create a conflict for the purpose of the show. However the correct thing for the nurse to do is call the code, begin compressions and manually bag the patient until someone who is authorized to intubate arrives.

[sarahluckyky]

No, ACLS does not teach you how to intubate. You learn algorithms for different rhythms, like which drugs to give, when to give them, when to cardiovert, etc... You will go over artificial ariways, but you won't learn to intubate.