I was talking with a couple fellow SRNA and CRNA's the other day. Someone relayed a story that we had all had similar experiences with. It seems to happen most in the OR. It has to do with non anesthesia personel "helping" you. The one CRNA was ready to place her ET tube. The circulator had helped her by placing the tube into a "C", instead of the hockey stick she had fashioned it into. The circulator had been a paramedic who told the CRNA this is how it goes in best. My personal run-ins have come mostly upon awake extubations where you want the patient doing a tap dance before you pull the tube. The guy was over 300 pounds, massive GERD who was obviously an RSI. As he's coming up, he is coughing and bucking. Face is four shades of red. The circulator very nastily said, "Are you gonna pull the damn thing? I think he's had enough!" I didn't have the time or inclination to explain aspiration pneumonia. This scenario seemed to be the most prevelant. Another had done an SAB. The sympathetic blockade had rendered the patient very hypotensive. At the end of the case that was shorter than expected, the circulator sat the patient up in the bed while the CRNA was gathering her things for PACU. After a return to supine and some ephedrine his pressure went back from 50 to 100.
No one seems to care what problems were caused or could have been caused. I try to explain things nicely. Others do not. In either case few seem receptive. My point, other than venting, is that I think some people credit themselves with more knowledge than they have. I used to work in the OR. I was one of those people. Now that I've seen both sides, I can really see how dangerous this mentality can be.
Disclaimer! I know there are alot of intelligent people who do a wonderful job helping anesthesia. I am also not claiming to be perfect myself. My target audience is people who don't even know they are dangerous.
