Intubation Question

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Hi all,

Ive been working in ER for a year now and have a good grasp on things. I have not however been working when a pt needs to be intubated. In small rural hospitals it is basically just the md and rn.. does anyone have any advice or comments regarding important things I should know for when I am involved in such scenario?

Thanks!

Specializes in CCT.
I think you have been given some excellent advice already. One of the things I see new nurses freak out over, is the order in which to give RSI meds. You do not want your patient to be paralyzed and NOT sedated!!! Talk to the doc, find out what meds he/she will want and make sure you know which one is the sedative and which one is the paralytic.

This, dear lord if you get nothing else pay attention to this. There is nothing worse than walking into a room and realizing your patient is literally shedding tears because no one bothered to sedate them post intubation.

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Specializes in PACU, OR.

OP, if you have some spare time, why don't you arrange with theater staff to go up and observe a few inductions? You can ask to assist with a couple of intubations AND learn how to apply cricoid pressure, so you know how to do it properly.

I would suggest you contact the theater UM and ask what would be a good time for you to go there, ask the circulating nurses if they can show you some of the equipment, especially the difficult intubation tray, and explain how to use items such as the McCoy and the fibreoptic scope. Choose a nice, friendly anaesthetist or CRNA who enjoys teaching, and get some hands-on experience.

I don't know if you'll be allowed to intubate, but if not, you can always practice on a dummy-it's a very useful skill to have; also, if you haven't already done it, I would practice inserting a laryngeal mask airway.

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Specializes in Emergency.

Maybe a little off-topic, but with a rural hospital, you may want to see if backup airways are also available. I have used a King Airway a few times in the field without any difficulty. If you have the exchange device on hand, it's pretty easy to replace the King with an ETT tube when you're ready to replace this temporary airway. They are invaluable in our small EDs here and also are mandatory to be stocked in our EMS services (field intubations don't have the benefit of good lighting, adjustable beds, and so on... yet, the patient needed his airway secured long before you even got there! lol!). Just a penny's worth.

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Bright and tight!

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Bright and tight!

LOL ... I like to say "bright, tight, and white ... like a sailor's pants." :D Hahaha!

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LOL ... I like to say "bright, tight, and white ... like a sailor's pants." :D Hahaha!

Never heard the sailor's pants line, lol.

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

That's because I made it up. :) Grew up around the Navy, what can I say? It helped me remember it during medic school. LOL

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Specializes in ED staff.

ACLS! Now!

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Specializes in CCT.
ACLS! Now!

ACLS really doesn't cover the assisting in airway control.

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Yeah, ACLS assumes you learned that elsewhere. That said, I think we had to stick a tube down an intubation dummy the first time I took the course...or mill around at least acting like we were interested in doing it.

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