Nurses and extubation

PA-C in Texas · Apr 5, 2004

ACLS is not a certification for intubation. ACLS protocols state only the most experienced person should intubate. I don't want that liability and there is some confusion out there with some who think because its covered in ACLS, we should be able to do it. Not so.

Yeah, you really can't learn advanced airway management in a 16 hour class.

ethelbsnrn · Apr 5, 2004

In the Philippines, we do not have RT's. We do the changing of vent settings, extubation, with the primary parameter - the O2 sat- reading, and of course the usual physical assessment thing.

kyti · Apr 5, 2004

We often extubate in the pacu,but it is at the direction of the anethesiologist or CRNA. When I worked in the ICU sometimes we extubated but usually the RT extubated under the direction of the pulmonologist or primary care Dr.

athomas91 · Apr 5, 2004

there are of course nurses (flight) who are trained to intubate (that is a whole different subject)....i was primarily talking about extubation...i personally wouldn't want to do it as a nurse on the floor/icu/ED - i have seen what can happen - and i don't care HOW good of a nurse you are - if you aren't advanced trained in airways - you have nothing to save your butt when that pt crashes and the family lawyer goes for the jugular.

duckboy20 · Apr 6, 2004

The hospital I come from physicians, anesthetists, or RT's can extubate or intubate. Nurses do not do so at all, unless they are ACLS and like everyone said, the only potentially qualified person around.

NeuroICURN · Apr 6, 2004

We extubate in our ICU all the time...and generally, the only other person I need is someone to shut off the vent when I pull the tube! LOL

Seriously though...usually, our people are those that are on the vent for a while, so we too, have certain steps that we go through. Of course, there's also lots that we end up having to trach and peg.

Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!

Palpitations · Apr 6, 2004

Yeah, I can back you up on that! I had one! Every damn time I tried to lay down to go to sleep, I'd have to get right back up to suction the darn thing! If it wasn't that, I was changing the dressing. It wasn't no fun at all!

Melinda

We extubate in our ICU all the time...and generally, the only other person I need is someone to shut off the vent when I pull the tube! LOL
Seriously though...usually, our people are those that are on the vent for a while, so we too, have certain steps that we go through. Of course, there's also lots that we end up having to trach and peg.
Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!

mattsmom81 · Apr 6, 2004

Can anyone else back me up on the fact that there's nothing more disgusting than a new trach! Yuk!

A stinky old one with copious spewing secretions ...and Lord knows what bugs in it (had one with GC once...uck) :uhoh21:

Palpitations · Apr 7, 2004

you took care of a patient that had gonorrhea in his/her trach? now, that is nasty! i'm sure that you went in the room with a face mask and gloves on! i know with my trach, when i coughed, i could shoot mucous across the room!

i sure would hate to get a gc loogie blown on me!

melinda

a stinky old one with copious spewing secretions ...and lord knows what bugs in it (had one with gc once...uck) :uhoh21:

CHIRN · Apr 7, 2004

In general, a great majority of our patients like to extubate themselves. :) We just go with the flow.....

NeuroICURN · Apr 8, 2004

In general, a great majority of our patients like to extubate themselves. :) We just go with the flow.....

That's what restraints are for!!! The majority of our intubated patient's get restrained until they prove they won't extubate themselves.

leslie :-D · Apr 8, 2004

i was taught in school on how to give emergency tracheotomies. the example set forth was if you were in a restaurant and were unable to heimlich someone effectively, then you'd insert a sharp instrument inbetween the cricoid cartilage (i think 2nd-3rd) then insert a straw until emergency personnel got there.....now tell me that's not scary. does that cover us under the Good Samaritan Act?