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Discussion

Intubations/Codes

Here recently (within the past 2 months) it seems like it takes forever for an MD intubation. It seems like even though respiratory is primarily located on the other side of the building, they can get there quicker than an MD that is next door to the code (exaggeration).

In any case: during a code, who does the intubation's mostly? I've found it recently that RT's have been performing most of them. In addition, if an MD is not present do any of you have PA's or NP's run a code? Is this even an option in your facility?

Just curious to see what others have to say. Thanks!

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Over here we would only intubate if the patient once the anaethatist is present and only then if the patient is definately a candidate for ICU care. ALthough this may sound harsh once they have arrested the chance of survival is really poor and the majority will have significant co-morbidities. I guess that less than 25% will be tubed.

As far as non doctors running arrests, in the last hospital I worked in I ran all of the cardiac arrests I attended usually using it as a teaching expereince for the medics who were present, I was responsible for training all hospital staff and auditing all emergency calls. I attended all cardiac arrest calls within office hours.

Now as a NP I will run a cardiac arrest if I feel the needc to but tend to encourage the doctors to do so for them to gain the experience.

Please bear in mind that this is in the UK so hospitals run slighly differently over here

After working in alot of different regions of the country, I think the airway is managed by different specialties regionally. I worked in one place where the ICU Doc's did all the intubations (including the ER), one place where RT's did 'em, one where NREMT-P's based out of the ER did 'em all, and one where only anesthesia did 'em.

I have seen the same variations in who runs the code-ICU RN's, Anesthesia, ICU doc's, ER doc's, NP's.

Remember- most of these decisions as to who does what are made based on specific hospital resources. A small hospital in the middle of nowhere has different provider availability than the Huge teaching hospital where doclings knock each other over to get the chance for any procedure.

Doclings :lol2:

RT could intubate, but rarely did as anesthesia responded immediately. Our hospital allowed ACLS certified nurses to run a code, again not often necessary since we had hospitalists who responded to all emergency codes.

I'm calling all the residents doclings from now on, definitely.

In our NICU either the neo fellows or the NNPs intubate and run the code. If it's a CT surgery pt then if the CT fellow or NP is able to make it over then he/she will often take over. Once in a while the attending neonatologist will run a code, or show up at the end to call it. Our RTs are badly misused and pretty much only set up vents and run iStats - they'd probably let me intubate before one of our RTs.

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Thanks for the responses so far.

After working in alot of different regions of the country, I think the airway is managed by different specialties regionally. I worked in one place where the ICU Doc's did all the intubations (including the ER), one place where RT's did 'em, one where NREMT-P's based out of the ER did 'em all, and one where only anesthesia did 'em.

I have seen the same variations in who runs the code-ICU RN's, Anesthesia, ICU doc's, ER doc's, NP's.

Remember- most of these decisions as to who does what are made based on specific hospital resources. A small hospital in the middle of nowhere has different provider availability than the Huge teaching hospital where doclings knock each other over to get the chance for any procedure.

LOL! Doclings! *remembers*

Doclings :lol2:

Ok, No offense.....but AWESOME!!! Secretly gonna call all students and residents Doclings!!!!! Thank you for that!!!:bow::bow:

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