RN intubation in ED?

AlexCCRN · Nov 28, 2005

Depends on the facility. ER nurses should be ACLS certified and therefore have rudimentary intubation skills and are expected to be able to accomplish intubations as part of the ACLS requirements. Yes, RNs could just as easily be as competent as an RT or EMTP or MD in the skill but it might appear as an encroachment if RNs routinely did it. IMHO.

Keicha RN · Nov 28, 2005

Depends on the facility. All ER RNs should be ACLS certified and intubation is an ACLS skill. However, I work in a teaching hospital and usually, it is the resident who attempts and if unsuccessful, the attending physician intubates. We nurses just do all the other stuff.

Trauma Columnist · Nov 28, 2005

In the smaller, rural hospitals, I can see this (perhaps) happening. However, in the larger, teaching hospitals, there are waaay too many people that want to intubate.

mtnmom · Nov 28, 2005

I don't know about other states but in GA intubation is not in the scope of practice for RNs as defined by the state BON.

heartICU · Nov 28, 2005

Depends on the facility. ER nurses should be ACLS certified and therefore have rudimentary intubation skills and are expected to be able to accomplish intubations as part of the ACLS requirements. Yes, RNs could just as easily be as competent as an RT or EMTP or MD in the skill but it might appear as an encroachment if RNs routinely did it. IMHO.

Be careful here. Taking ACLS and receiving the card does not "allow" you to intubate. Intubation on a dummy in a one day class and intubating an emergency in the ER are two very different things. They do not even compare to one another. Airway management is not nearly as easy on a real person as it is in ACLS, especially during an emergency. Yes, RNs could be equally as competent as an RT or EMTP or MD in that particular skill, as long as they have had the proper training - but ACLS does not provide the necessary education/training to be able to effectively manage an airway. Check with your board of nursing to make sure.

KatieBell · Nov 28, 2005

Be careful here. Taking ACLS and receiving the card does not "allow" you to intubate. Intubation on a dummy in a one day class and intubating an emergency in the ER are two very different things. They do not even compare to one another. Airway management is not nearly as easy on a real person as it is in ACLS, especially during an emergency. Yes, RNs could be equally as competent as an RT or EMTP or MD in that particular skill, as long as they have had the proper training - but ACLS does not provide the necessary education/training to be able to effectively manage an airway. Check with your board of nursing to make sure.

I agree with the above. ACLS and the dummy don't provide necessary training to manage an airway. One needs to go to the OR and do a lot of elective intubations before trying to manage an emergency airway.

I also think its out of the scope of practice in the 3 states I am licensed in ...

suzanne4, RN · Nov 28, 2005

Intubation is no longer a required skill in the ACLS classes for RNs. The same way that central line insertion used to be included and RNs were responsible for being able to demonstrate on a dummy, but that is no longer the case.

Intubation is not see one, do one. Most states do not have it as an approved procedure for RNs, unless you are a flight RN, etc.

vidorfire249 · Dec 3, 2005

intubating in the hosptal is not just about performing a skill.

Consider...

After you intubate are you ready for the respnsibility of the ventilator settings?

Will you read the x-ray to confirm the tube posistion is optimal?

What if the patients respiratory status doesn't improve after you intubate?

who will mangae & be responsible for the sedation/anesthesia?

I was a paramedic/firefighter 17 years before I became an RN this year. Passing a tube on a call is far more easier than the management of it for hours in the ER. Just because you have ET tube taped down dosen't mean the patient is safe.

Spacklehead, MSN, NP · Dec 6, 2005

Hi All-
I am currently working through my ADN and would like to be an ED nurse.
I am currently a Fire/Medic and enjoy that.
My question may be silly but do any of you ED nurse have the ability to intubate in your respective ED's? I know of a rural ED near my home where they have been known to have the local EMS dispatched to perform intubations when Doc is having trouble. I always wondered why they wouldn't train the RN's to do that.
I was just curious:p
Thanks

Sounds like the hospital I used to work for! :lol2:

berry · Dec 7, 2005

I have got to agree with above an ACLS card in no way should make a RN comfortable intubating a pt. Intubation is way beyond RN scope of practice according to most states BON.

allnurses Guide · Dec 7, 2005

Intubation is outside our scope here too. But having learned it on the dummy, I am much readier to assist/know what to expect when we are intubating in a code or trauma. EMS are good at doing difficult tubes in the field, but their work gets rechecked in the ER, xrays etc. I have enough to do in a code/trauma without adding that procedure! Not that I haven't wanted to try it sometime, but ...