I hear many of you talking about RT/doctors etc... required to be at your deliveries for infant intubation/cord viewing purposes. This is a nursing job at our facility. Many of our nurses are hesitant to do this and we are going through an issue right now during which an infant was coded and neither nurses nor anesthesia attemped to intubate. Surgeon ended up leaving an open uterus (breaking scrub) to do the intubation. Our chief OB is up in arms!
Many say that we shouldn't have to intubate if anesthesia is on the floor. Anesthesia's argument is that the infant is not their patient. Our NRP instructor says that as L&D nurses we are more qualified than anesthesia to intubate newborns. Because we have more oppurtunity to do it. Generally our peds agree with this. In the OR anesthesia uses devices that occlude the esophogus when operating on an infant/child.
For those of you that do intubate... how successful are you at doing it and how comfortable are you with it? Do you practice only on dummies or do you practice with anesthetized kittens?
They DO teach and practice INTUBATION in NRP. We had to intubate anesthesized kittens way back when, I remember, and I remember being horrified too. (this activity WAS supervised by the humane society, by the way). We do it on DOLLS now.
But on a real baby, nope, I would NOT want to do this. In ANY high risk delivery, a PEDS must be present where I work.....this would include many things such as really bad fetal strip, extreme prematurity, mod to thick mec staining, etc. I can see a situation where there is NO ONE right away to intubate. Still won't do it. I will bag/mask baby, do compressions, having suctioned all I can first, but not intubate. We have anesthesia and doctors to do that and that is in THEIR scope, not mine. JMO.
What Deb said, except haven't been around long enough to practice on kittens, have only used dolls, Thank Goodness!, and only have FPs but have an MD or CRNA and RT back up, although RT usually is just there more for setting up a vent or to assist, have never seen them intubate.
I remember learning about intubation and practicing on dolls during my last NRP classes but we were never expected to actually do it. We always had anesthesia or a doc do it. I agree with SmilingBluEyes.....I won't do it....to much risk for me. Not in my scope of practice. I do remember a C-Section once where if I had not have a CRNA present in the room I would have lost a baby because the attending peds doctor was just standing there looking at me struggling to make this baby breath. The CRNA left her position with the mother long enough to help me intubate and resuscitate this baby.....even the OB doing the surgery was upset with this peds. Thank God nothing happened to either mom or baby. Both turned out great. :balloons:
BRANDY LPN
408 Posts
What Deb said, except haven't been around long enough to practice on kittens, have only used dolls, Thank Goodness!, and only have FPs but have an MD or CRNA and RT back up, although RT usually is just there more for setting up a vent or to assist, have never seen them intubate.