what would you do!!!!

[sweetnurse63]

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?

[tewdles, RN]

Back in the day intubation was part of the ACLS training...IF (and that could be a really big IF) I remember correctly.

Given that I am an "old grumpy nurse" we might expect that Sometimers disease could play a small role in my frequent difficulty with memory.

[sarahluckyky]

Intubation may have been included in ACLS in the past, I do not know for sure. I took my ACLS in February 2011 and we did not learn intubation.

[applewhitern, BSN, RN]

Nurses "once upon a time" could intubate; this is why they used to have the intubation stuff in ACLS for nurses. The doctor, nurse, or resp. therapist could intubate. Now they have taken most of the resp. stuff out of ACLS. "Way back when" whoever could get the tube in did it. Now, several of the hospitals I have worked at do not allow nurses to intubate. I really do not know why this has changed. More dumbing down of the nursing profession I guess.

[applewhitern, BSN, RN]

Oh, yes, we used to have to intubate in ACLS! And much more stuff they have taken out.

[canoehead, BSN, RN]

If the patient is still breathing the nurse can put in and airway and bag until someone can intubate. Hit the code button at the same time and you'll have help within 30 seconds. So in real life it wouldn't be a do or die issue.

[canesdukegirl, BSN, RN]

I specifically remember learning how to intubate during my ACLS class. I vividly remember my instructor telling me not to "rock the blade" onto the pt's teeth, but instead pull up and out in order to get a clear view. I also remember how weird it was to use the Mac blade in my left hand because I initially held it with my right-dominant hand.

That was 8 years ago. I guess things have changed?

If a doc is standing right next to me and is frozen in place during an emergency (this just happened to me a few days ago-I had to walk this terrified intern through the next steps while trying to prepare the surgical field for an emergency x-lap), I would walk them through what to do. I am not ACLS licensed any longer, but still remember the steps of intubation. If I had to put the blade in their hand and stand behind them to assist with intubation, then I would. However, before I did that, I would have asked my charge nurse to page the attending STAT!

[canesdukegirl, BSN, RN]

This is straight from the NC BON:

"RN who accepts responsibility of monitoring status of the patient cannot assume other responsibilities such as performing a procedure which would leave the client unattended, thereby jeopardizing the safety of the client. (For example, while endotracheal intubation is within the scope of practice for the RN, a single RN could not be simultaneously responsible for both the medication administration/monitoring activities and the intubation itself.)."

22) Endotracheal Intubation - Endotracheal intubation is within the scope of nursing practice for the REGISTERED NURSE.

Although I understand that not all states are the same in regards to the scope of practice for an RN, I thought that I would share with y'all what my state's BON considers acceptable nursing practice.

[nurseprnRN, BSN, RN]

do not ever mistake hospital tv drama for reality. ever.

http://www.truthaboutnursing.org

[guest64485]

At my last ACLS class, they told us they were not required to teach intubation anymore because they only wanted people intubating if they were going to be frequently doing it. They said that it was more a skill learned from practice and frequent use, and that a barely-trained person or someone who hadn't done it in a long time could do more harm/injure the patient they were trying to intubate.

They gave examples of people breaking the patient's teeth (and the broken tooth falling into the throat) and another example of someone using the wrong size on a child and severely damaging the throat/vocal cords, and another example of someone repeatedly failing their attempt, and then when a more skilled person tried, the throat was too swollen to proceed so they had to do a trach.

They then taught us how to intubate as a fyi, but told us not to do it unless further trained.

[diva rn, BSN, RN]

Yep, learned to intubate with ACLS in 1991...never used it, but learned.

[sweetnurse63, BSN, RN]

Wow!!! I never knew that years ago nurses were taught to intubate. I think it should be part of acls because most of the time nurses are the first responders when a patient codes. What a dynamic skill to have!!!!!

[tewdles, RN]

I was actually taught to intubate in my clinical setting for pediatric and neonatal transport. I did learn to intubate adults during ACLS though, actually used it once as a first responder to an accident...an anesthesiologist and myself were first to the scene. Pt airway was compromised in the vehicle and the anesthesiologist couldn't get into the space to secure the airway...so I did. That was some high anxiety stuff right there...but fun.