is it muscle or technique for intubating?

Specialties CRNA

Published

Hi all,

It's been a while since I posted (adjusted to the shock of starting classes 3 months ago and all the studying/tests etc). We practiced intubating the mannequin yesterday. I had a really hard time lifting the mandible with the MAC blade (miller seemed to work a little better) but with both felt like my arm was straining. I purposefully made sure I wasn't using the wrist bending action and was lifting up and away but still felt like my arm was going to fall off! I also did not use the 'chicken arm' move but kept my elbow close to my side. My 2 other female classmates said their arms were straining as well. My instructor said it doesn't require muscle we just need to work on our technique (some of the guys were straining also).

I'm really worried that I won't be strong enough to intubate. I know they say it's technique, so how long does it take to acquire technique!! We start intubating in the OR next week!!! Any tips (I'm really hoping it's was just hard on the mannequin because it is so stiff and on patients their jaws will be a little more flexible!). HELP!!

At one place I worked we intubated sedated ferrets during PALS. Those teeth sure are freaky! (we went to the clinical research lab attached to the hospital)

They should just throw those mannequins out the windows!! They are nothing like intubating a person in my opinion. Laryngoscopy takes some strength, but it is much more about technique. Once you start getting the technique down you will find it requires less strength than you think. I am only in my 4th mth of clinicals & I can tell a huge difference now.

good luck!!

They should just throw those mannequins out the windows!! They are nothing like intubating a person in my opinion. Laryngoscopy takes some strength, but it is much more about technique. Once you start getting the technique down you will find it requires less strength than you think. I am only in my 4th mth of clinicals & I can tell a huge difference now.

good luck!!

Agreed, those are about as life like as Michael Jackson

Thanks for the input, it really helped me calm down! Yesterday we did practice again and it went much smoother but I found I tended to 'rest' my forearm on the mannequin's head. It took less muscle and was actually able to see the airway without straining!

Next, we did LMAs-any tips for folks with small hands and short fingers-I'm wondering if I will be able to push it back far enough for a good seal-does it matter if I use my middle finger instead of index?

funny thing about LMAs

a neat trick for LMAs that just don't go down right:

- use either a bougie or an OGT and advance it down the goose, then advance the LMA over the bougie/ogt into the mouth - until it sits... there you go!

One more important thing. Getting your blade into the mouth, and into the back of the pharynx can be the toughest part. The scissor technique will allow you to easily deposit your blade with out playing bumper cars with their teeth. The tongue usually shows itself out of the way also with good enough exposure. You will spend 20 seconds just fumbling in their mouth if you don't get it open and retracted enough.

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