learning to intubate

Don't worry about it dude. Keep trying, eventually it will become as routine as starting an IV. As a side note, I have heard that using the maxillary incisors as a fulcrum earns you mega bonus points with the CRNAs and attendings.

im not a CRNA but i have worked in surgery for a total of 10 years. I have had the privilege of intubating a couple of times(patients did not have teeth). I have asked this same question of all CRNA's that i had the honor of working with and they all said patients without teeth are easier (of course) because u can concentrate more on the anatomy and not have to worry about replacing a tooth. Also with the different intubation tools( mac vs. miller, LMA, etc) you just have to find the right one for you!!. Good luck!!! I think all people who are willing to go into the anesthesia field are 1 of a kind!!!!

It probably took me about three or four times. The hardest thing for me was getting used to looking at the "real" anatomy as opposed to intubating a dummy. The first time I put the blade in someone's mouth I was like, "what the h*ll am I looking at?" But after I got used to the anatomy, it became much easier. Best of luck to you!!

I have always found intubating to one of the more difficult things in medicine to perform. If you consider the training.............most of the time you are either doing it on a dummy, learning in a code where time is VERY limiited and everyone is in a panic or doing it as an emergent or semi emergent procedure. As a RT, I had to rotate through OR to learn. I read everything I could find to read and even got in on intubating cadavers which helped a lot. Get an anesthesiologist or a CRNA to help you with your technique and you will get it eventually. Also, the choice of a MAC or Miller blade is a personal preference. People can usually work with a MAC easier, however sometimes it is easier to see with a Miller. Good luck.

I have had LUCK intubating with a MAC blade but my Miller blade stats are about 60%. I find when I cannot get a good view with the MAC, it is usually because I haven't swept the tongue far enough to the left. I sometimes just push upward and midline and when I am cognizant of my technique, I push upward and left and this usually sweeps the tongue and displaces the epliglottis enough for me to see the cords.

I am still working on my Miller skills but I have been told that if you enter the blade to the farthest right, it will assist in movin the tongue when you push to the left. I know it sounds easy but I haven't truly gotten it yet.

Good luck!!!! Maybe you can practice on the mannequin with a friend to see if they can see what you can maybe try differently...sending you positive vibes!

I missed my first got my second and went up and down for the first month until my ups were all I had, it is just a motor skill anyone can perfect if they practice. Just remember to take your time. If you preoxygenate well you can screw around for 5-6 minute everything just the way you want it practice the sequence of events in your head, induce, perform said steps calmly and methodically, the patient is not going anywhere and will be fine, so what if it takes 2 minutes? In time you will get good and before you know it you will get that tube in PDQ every time, just remember to always make your first shot your best shot.

I have always found intubating to one of the more difficult things in medicine to perform.

Surely you meant "More difficult things in Nursing." :wink2:

I am not a CRNA, only a flight rn--but we intubate peds and preterm babies.

I completely understand your woes. It usually takes me several looks--but I am pretty new at it.

You can not imagine how small the airway of a 25 week (gestation) preterm baby is---- it is a "white knuckle experience".

cb

I have complete respect for paramedics & flight nurses it is bad enough trying to intubate under controlled circumstances. I don't even want to try to intubate someone outside of the hospital at this point....and I can't even imagine trying to intubate someone in moving vehicle!

All the former RNs who were former medics appreciate the acknowledgement.

Intubating in a controlled environment like the OR can present enough challenges... without the stress of having to intubate a patient in cardiac arrest who is wedged between their bed and the wall (with poor lighting of course and aspiration of course) which just adds another unwanted variable to an intubation scenario.