Did you get your first intubation?

Specialties CRNA

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Did you get your first three? I'm 0 for 3 now, and getting frustrated. The first time, I couldn't get a view of anything. I felt better about that one though after the CRNA I was with said that the patient's airway was odd (it was deviated far to the left), and he had a little trouble visualizing the cords too. That's the only one though that I can rationalize by weird anatomy. I've missed two others since then. *Sigh*. I've practiced in lab with the mannequins and such, but it is so different when you're doing it on a live person. Everyone in the OR is staring at you, you're trying to relax and take your time, and suddenly "DING, DING, DING..." - your alarms are going off, and you're thinking "OMG, I have to get this tube in you!" It's just frustrating, and I think I'm the only person in my class to have missed all their attempts so far.

Serves me right, after running my pie hole, I missed yesterday!

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Me too! I haven't been in the the OR for like two weeks, and I missed an easy one yesterday. I have no idea why but I couldn't lift the guy's big ol head, I need to do some one armed pushups!

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Whats a Robert-Shaw?

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Whats a Robert-Shaw?

It's a double lumen endotracheal tube used for mainly thoracic cases.

It gives you the ability to deflate a lung while keeping the other inflated. This allows the surgeons to work on a smaller, non-moving object. It also allows you to separate the 2 lungs if there is infection in one.

They can be difficult to insert and most use fiberoptic bronchoscopes to check placement.

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Learn something new everyday. Guess my day can end now. (Boss wont like that very much though because I still have 11 hours left of my shift)

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I'm not a CRNA student, but when I was in paramedic school, I missed more than a few. I am definitely a Miller type of girl...the Macintosh just seems to take up so much space in the mouth. I got a lot of great advice from the anesthesia docs...they are so smart and so supportive! You CAN do it!

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Specializes in Anesthesia.

:balloons: :balloons: I GOT ONE!!! :balloons: :balloons:

I've been so excited about that all day. I finally got one!!

Thanks for the encouragement :) .

Lou

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:balloons: :balloons: I GOT ONE!!! :balloons: :balloons:

I've been so excited about that all day. I finally got one!!

Thanks for the encouragement :) .

Lou

CONGRATS!!!:Melody:

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Specializes in Anesthesia.

Thanks. I tried the Miller like some folks suggested to me here, and I got it with that. I was so excited! Not that I feel secure in that skill now or anything. I tried three in total yesterday, and only got the one, but it was at least enough that I don't feel as completely discouraged as I did. Thanks again to everyone here who has replied. A friend of mine in classes with me has been perusing this board and came across this thread, and mentioned it to me. He said it seems like there are a lot of knowledgable and supportive people here. I absolutely concur!

Thanks again,

Lou

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Hey Lou!!

Just wanted to let you know you are not alone. Today was my first day in the OR-got there at 0615 like was told.Here's my day: My CRNA didn't get there til 6:50 (by now I'd had plenty of time standing around psyching myself out bigtime!!!) got to the room-no machine check done since running late.(we have not covered this yet so I don't know how to do it yet) next no O2 sat probe cord-sent me to find a tech and get one (couldn't find tech-looked in workroom in box labeled sat probes-nothing-back to room emptyhanded :o ) he had drawn up all the meds by then. off the preop to get pt (now feeling flustered). back to OR room. CRNA & MDA prep pt-I stand in back holding Mac w/#3 ready (all I can hear now is my heartbeat and blood pounding in my ears) they push all drugs including paralytic-bag once or twice to see if can ventilate the step out of way and I go to head of bed (-remember pt has already gotten rocuronium so feel must jump on it-they lower the bed to my HIP height-pt head is at my belly button- so now I'm bending over)-get blade in mouth can't see anything-they tell me to pull back-do and now see epiglottis and lift-think see cords-not sure, sats dropping to 88%-CRNA takes scope and lifts-see cords great and get tube in but sats now 85% :crying2: !!! bag back up quickly to 95%-my legs are shaking!!! self critique:

1)pysched myself out to start with

2) bed to low-I'm looking straight down in mouth not at an angle

3) blade in too far to start plus first time so not sure what REAL cords look like!

4) now just annoyed at myself! how can you possibly miss a MP 2, view of cords grade 1 and pt with no teeth :uhoh3: will carryon and hopefully learn from my mistakes for next time!!

How are you doing with the Miller ( I thought it was a little easier on the dummy w/Miller so maybe I'll try it next time)

kestrel

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Specializes in Anesthesia.
How are you doing with the Miller ( I thought it was a little easier on the dummy w/Miller so maybe I'll try it next time)

kestrel

Well your experience sounds much like mine, kestrel! I'm actually liking the Miller, though I've been alternating between the Miller and Mac. I miss an equal amount of intubations with either blade it seems like, but I feel like I have an easier time staying of the teeth with the straight blade.

Lou

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Specializes in MICU.

"just wanted to let you know you are not alone. today was my first day in the or-got there at 0615 like was told.here's my day: my crna didn't get there til 6:50 (by now i'd had plenty of time standing around psyching myself out bigtime!!!) got to the room-no machine check done since running late.(we have not covered this yet so i don't know how to do it yet) next no o2 sat probe cord-sent me to find a tech and get one (couldn't find tech-looked in workroom in box labeled sat probes-nothing-back to room emptyhanded :o ) he had drawn up all the meds by then. off the preop to get pt (now feeling flustered). back to or room. crna & mda prep pt-i stand in back holding mac w/#3 ready (all i can hear now is my heartbeat and blood pounding in my ears) they push all drugs including paralytic-bag once or twice to see if can ventilate the step out of way and i go to head of bed (-remember pt has already gotten rocuronium so feel must jump on it-they lower the bed to my hip height-pt head is at my belly button- so now i'm bending over)-get blade in mouth can't see anything-they tell me to pull back-do and now see epiglottis and lift-think see cords-not sure, sats dropping to 88%-crna takes scope and lifts-see cords great and get tube in but sats now 85% :crying2: !!! bag back up quickly to 95%-my legs are shaking!!! self critique:

1)pysched myself out to start with

2) bed to low-i'm looking straight down in mouth not at an angle

3) blade in too far to start plus first time so not sure what real cords look like!

4) now just annoyed at myself! how can you possibly miss a mp 2, view of cords grade 1 and pt with no teeth :uhoh3: will carryon and hopefully learn from my mistakes for next time!!"

omg - all this pressure. i think i would have hurled! i know you get used to it as you get more comfortable. i tend to lose it when i am really nervous. just curious, is there a trashcan/biohazard near where you are standing? did nerves get to anyone else (to the point of being physically ill) during their first few days?

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