KatieC Posted March 13, 2007 Posted March 13, 2007 I'm an EMT-I student and am really liking the class so far, but intubations are killing me. I've had 8 attempts and only 1 successful intubation during clinicals. My instructor says my technique is good, and he's not sure why I'm having problems. The doctors/CRNAs that I've been working with in clinicals have given me constructive criticism and some very helpful pointers. I don't know if it's because I'm getting difficult patients during clinicals (docs have commented about how difficult several of them were, and a CRNA that took over after me placed the tube in the esophagus of one patient) or what. I think I'm also a little bit intimidated by the anatomy of a real, live person, plus being in the OR setting where it feels like I don't know what the hell I'm doing compared to everyone else there. Of course the commentaries from a few nurses don't help ("They let EMTs intubate?!? I didn't think they even let paramedics intubate anymore!"). I've viewed the youtube video that was linked on here, and I have no problems intubating mannequins in class. But we only have 2 weeks left of class and if I don't get 2 more tubes, I don't pass. I am applying to the paramedic program for January 2008, but I'm having serious second thoughts about it after taking this class. Especially if I don't get my intubations. Has anyone else had this problem, or does anyone have any tips? Thanks, Katie
VentMedic Posted March 13, 2007 Posted March 13, 2007 I put myself in a different state of mind by imagining the adult handle as the handle on a beer stein or the baby handle as a fine wine stem. I look the person at the foot of the bed square in the eyes before I start to intubate. Then when in position I take a deep breath and mentally say SALUT! to the person at the foot of the bed. This works for me when the is room full of commotion. Relax...don't let anyone shake your confidence.
Medic2588 Posted March 13, 2007 Posted March 13, 2007 What I find helpful, when physically possible, is to pull the patient to the head of the stretcher so his/her head is dangling off the edge. Then I elevate the stretcher to about a 45 degree angle. This puts the body in near perfect alignment. It then becomes very easy to move the jaw out of the way to see the airway. Grants, this is not possible if the patient is a trauma patient or a retracted elderly patient. Devin
Spock Posted March 15, 2007 Posted March 15, 2007 VentMedic just gave you some awesome advice! I would say you might practice more on the mannequin with someone holding a stopwatch over you and placing the mannequin in the worst possible position. I have a research project underway where experienced paramedics have to intubate the mannequin every shift. So far there as been an improvement is success rate for those practicing on the mannequin. Don't get discouraged. Do get as much field experience as you possibly can. Good luck. Live long and prosper. Spock
somedic Posted March 15, 2007 Posted March 15, 2007 How are you getting Paramedics to be your lab animals? Are you conducting research within a hospital based EMS system? What do you want to prove with your research? Sorry for all the questions. Somedic
EmergencyMedicalTigger Posted March 16, 2007 Posted March 16, 2007 What exactly are you having problems with..are you able to visualize the cords before you try the tube or can you even see the cords at all? What type of blade are you using-maybe you're just not lifting up enough? Remember, depending on the pt's anatomy you might have to use a different blade. I don't like using the Mac, but sometimes I have because it works better with some pts. Just ignore other's negative comments and take a deep breath-you can do this!
Dustdevil Posted March 17, 2007 Posted March 17, 2007 What exactly are you having problems with..are you able to visualize the cords before you try the tube or can you even see the cords at all? What type of blade are you using-maybe you're just not lifting up enough? Remember, depending on the pt's anatomy you might have to use a different blade. I don't like using the Mac, but sometimes I have because it works better with some pts. Just ignore other's negative comments and take a deep breath-you can do this! Dang, Girl! You just said everything I was about to say! Especially when you asked exactly what part she was having the problem with. Although it is a short procedure, there are a lot of potential individual pitfalls along the way. Breaking the procedure down into individual steps will help you identify the problems affecting you so that you can address them effectively. For instance, if you are having trouble visualising the cords, then that is a very different problem from having trouble placing the tube. Can you tell us more specifics?
ks_emt Posted March 17, 2007 Posted March 17, 2007 are you letting the fact that you are intubating a real person get you so nervous that you misplace the tube? and btw where are you taking your EMT-I from?
EmergencyMedicalTigger Posted March 18, 2007 Posted March 18, 2007 Dang, Girl! You just said everything I was about to say! Especially when you asked exactly what part she was having the problem with. Although it is a short procedure, there are a lot of potential individual pitfalls along the way. Breaking the procedure down into individual steps will help you identify the problems affecting you so that you can address them effectively. For instance, if you are having trouble visualising the cords, then that is a very different problem from having trouble placing the tube. Can you tell us more specifics? What?! I just said something Dust was thinking before he said it?? No way! :shock: I guess that means I'm learning something afterall. Maybe one day I'll *almost* be as good as you. 8) 1
sledogg1 Posted March 18, 2007 Posted March 18, 2007 Vent my man.........I think of the same. thang .......intubated the other day and thinking of wine or beer St.Paddies and ol and this has been 17 yrs, Dr could not do it vocal cords punched but hell the medic got it. Girl, YOU CAN DO IT!!!!!!!!!!!!!!!! JUST DO IT!!!!!!!!!!!!!!!!!!! lOOK......... SEE.......... PLACE THE TUBE........... THE puplic thinks we are drivers............we do it when no one can. See YA Tueday 36 hrs of in the guttters
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