advanced airway use

Specialties Emergency

Published

Specializes in Emergency Department.

Hi! I was curious as to the rules pertaining to nurses and utilizing advanced airways. Say its a busy night and you have no backup and your patient is coding. Are you allowed to use endotracheal intubation, combitube, king airway, LMA, etc? Is there a special class for that? Thanks!

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Specializes in Nephrology, Cardiology, ER, ICU.

Depends on your nurse practice act and your facility policy and procedure.

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Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

What TraumaRUs said and yes you need a class. You can't go monkeying around somebody's airway without training and a ton of practice.

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depends on policy and knowledge skills and experince, my facilty has a course called ILS that allows nurses to run a code until backup arrives we can place a lma

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Always ask what the policy states, if you go beyond this in a facility, it is not being a "good Samaritan" and you would be held liable for your practices.

Ambubag is quite sufficient in a code situation and waiting until proper practitioners are available to provide assistance with advanced airways.

Even if you are ACLS certified, it does not qualify you to intubate and place advance airways.

Check with your policy and guidelines.

Kirsten RRT, RN

(BLS/ACLS instructor)

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Specializes in Nephrology, Cardiology, ER, ICU.

In most cases, an arrest situation calls for CPR and BVM. There is not reason to go straight to an advanced airway as long as you can bag them with good chest rise.

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Specializes in Anesthesia.

I agree with TraumaRUs stick with BVM as long as it is working, and wait for someone who is experienced to intubate. When someone trys to intubate or use an advanced airway that isn't experienced in their use they usually just end up causing bleeding/edema in the airway, and it just makes the intubation that much harder. When BVM is not working and the patient is rapidly deteriorating then it is time to at least attempt some kind of advanced airway insertion as long as you have had at least some basic training in their use.

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Specializes in ER.

Yep, agree BVM done correctly works quite well until an advanced airway can safely be established.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If you are really in trouble and there is no one...call 911 and get the paramedics there.....ACLS has nothing whatsoever to do with whether you can perform intubatioin legally. Why? You are an EMT and in nursing school.....not within your scope of practice at all.

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How to perform high quality CPR and use an AED are the most important things you need to know. If the deterioration is respiratory, as others have said, BVM will work until more advanced rescuers arrive.

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Specializes in Emergency Department.

Ok thanks! I know its way outside my scope of practice for now. Do you happen to know NJ policy for those situations. I know the emphasis is on BVM ventilation and good CPR, but I am curious as to what is allowed.

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I agree that it will depend on scope of practice and facillity policy.

I do have a piggyback question. Here in MO, EMTs can use and are trained on the use of a Combitube. If a nurse was also an EMT and had a Combitube available used said Combitube on a patient, would they be covered under the scope of practice for an EMT, even if working as a nurse. Not a likely situation to occur, especially in an ED, but a curiousity question. thanks.

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