ICUisLife

Offlabel: Yes, you might be right! There is definitely that possibility, that he didn't give the succs time to work.

No, he did not use an airway. We switched to another bag as we thought maybe the bag/valve was malfunctioning, but it wasn't. Once he was finally intubated, bagging worked just fine.

I would like to ask for some of the more experienced ICU/critical Care RN's opinion. (I've only been an ICU RN for 2 yrs.) Last night we had a 33 y.o. repeated admission for PNA, (last admission a month ago with ARDS, hx COPD, drug abuse). He was deteriorating on HFNC and Dr. elected to intubate using Etomidate and Succinylcholine. He couldn't advance into the airway, so he pulled it back out. Patient's O2 continued to drop despite bagging, and eventually dropped down into 40's-50's (within about 1-2 minutes). Pt. became bradycardic and eventually arrested. Code was called, 1 round of CPR, 1 mg Epi, then ROSC with NSR. On second try MD successfully intubated with just a little bit of difficulty. He said that the pt. had a small oral cavity and the airway was difficult to access. He said there was no bronchodpasm or edema. My question is, why did his O2 not come up when the Dr. pulled the tube back out and we were bagging? What could have went wrong? Thanks for any input!

I know you'll probably think I'm nuts, but we live in Tacoma and I really grew fond of it. It has a beautiful North End at the Ocean (where we live) ...and it just has character... dark side and bright side... romantic and provincial, and gruff and urban... That makes it interesting. Lots of culture, lots to see, and, not to forget, several mid sized hospitals .... (eventhough I commute to Good Sam in Puyallup). Unfortunately, it looks like we'll be moving to South Prairie soon, though, since we own some property there and we want to build our house there... But I gues a tiny little town like S.P. has it's beauty...

Wow! I dont know wich state you live in, but I'm a hospital nurse in WA and I never have days when I am not running my a$$ off. And I wouldn't want to either. Reading a book on the job?? Out of question. Here I can give IV pain meds and of course hang IVPB. You can"t even do THAT??? Gosh I'm so glad I'm in WA! Oh yeah, and I admit patients all the time (except I have to ask the resource RN to do the first physical assessment.) ...And when I happen to have a slow day, there are plenty of colleagues that can use my help....

the only differces are, that: a) I can't hang blood (hospital policy, but they say soon to change), b) I can't give ativan and cardiac drugs and D50 IV push (strange, huh? ..since everything else I can give, including things like morphine, dilaudid or haldol...) I can't do the physical part of an admission assessment and I can't adjust a protonix, insulin or morphine dripp... Untill recently I couldn't give IV pushes through a central line, but that changed now.... Really can't think of any other differences... Oh, yeah... the pay :-) Silvia