It's Time to Intubate. Now What Do We Do?
ฝัง
- เผยแพร่เมื่อ 29 มิ.ย. 2024
- Reviewing what happens when its time to intubate! 📝 Free Quiz: COMING SOON
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Alright, so the time has come for whatever reason, and we need to intubate your patient. There are going to be a list of things that need to happen pretty quickly, from information to get from the provider, people to inform, and equipment to get ready. From there the nurses primary role is to administer meds and then monitor the patient during the intubation. Also once intubated we have some things to assess immediately after to ensure all is well. I do my best to cover as much of this as possible in this lesson!
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0:00 Intro
1:57 First things first
4:40 Equipment to have
13:05 Medications
14:41 Preparation
21:19 Intubation
32:50 Wrap up
#ICUAdvantage #Intubate #Intubation
I'm an anesthesia resident and I'm binge watching your videos. We rotate through the ICU a lot and I'm finding your content very helpful both for the ICU and in the OR. Keep up the good work!
So cool! Glad to hear you have enjoyed the videos and wishing you the best as you finish up your residency!
@Medical St same
Thanks a lot ICU advantage. IM resident and proud husband of a ICU RN / now NP. I learnt a lot from you. Genuine thanks.
Very cool! Thanks for taking the time to leave a comment!
Beautiful, comprehensive video. New to ICU and had my 1st patient intubation. Next time I'll have that liter of saline (we needed it). Amazing review of the process!
Thank you so much for this! Yeah I had definately been there without fluid back in the day. I get it. Glad this video helped in some way for the next time.
Thank you for this videos !! I’m applying to start working in the ICU and your content is extremely helpful for me to get ready for what is coming !😊
Excellent video Eddie. All your videos are very useful for us ER nurses as well. Keep these videos coming. Much love. 🫵👍👏🤩
Youre such a great ICU Nurse. Youre way knowledgeable than most doctors! Keep it up. Thanks for sharing your knowledge.
I appreciate the kind words but certainly not more knowledgable than the docs! Just doing my best to share quality info and glad you enjoyed it.
New grad ER nurse here and OMG! Im in love with your videos! SO helpful. It all makes sense now after graduating nursing school🥲
I swear everytime I think of a video you could do, you magically add it
Thank you for sharing your knowledge about nursing through your talent of teaching! I always find your videos so helpful in molding my practice and approach at the bedside.
Amazing educator. Thank you!
Pending the difficult intubation clip. Thanks for all that you do!
Many many thanks. Excellent and will go a long way for me. God bless you.
I sent it to all of our new ER RNs! I think this is great to "slow down" and know the whats and whys!
So cool! Thank you for helping to spread the word. Yeah the hope was to provide an opportunity to talk about it all, which obviously isn't going to happen well in the moment as the focus is on the patient and the situation.
Awesome! Working as a tech I had no clue how to help set up and was honestly a little terrified of being expected to help. I appreciate this video sincerely.
Edit: I appreciate all your videos haha
As I'm preparing for another ACLS certification, I'm going over basic ICU and ER topics as well, and this video is GREAT for pitfall proof preparedness. Thank you so much.
So great to hear this! Good luck on your recert! Really glad to know this video was well received.
thank you so much for the information, your video very helpful for me
Great presentation. Watching from South Africa
Thank you for utilizing RTs!! We’re the people behind the scenes but we’re always in place no matter what! 😊
Far from behind the scenes! Right there on the front line! We appreciate the crap out of you guys and we wouldn't be able to do it without you! ❤️
I love my RTs
Thank goodness for RTs!!! ❤
Yeah, RTs are everywhere. Except in literally every country except the USA...
Thank you so much , i just finish the whole video and its really a good refresher for me as I'm going back to grind in ICU . More Power !
Right on! Get some! Glad you enjoyed it and best of luck back in the ICU
Amazing as always!
Appreciate that Mohamed!
Very comprehensive! Thank you 👍
You're very welcome!
Thanks for sharing this great and detailed info!
My pleasure. Glad you enjoyed it Cassandre! 😊
You did a great job!@ Thank you so much for your videos!
Glad you like them and thank you!
The Liter of saline helps eliminate all the flushes needed, and also you have a bolus ready to go whenever. Biggest tip preceptor showed me.
Amazing.. Thank you so much
Outstanding lesson as always. Thank you so much
Thank you very much!
I love watching your videos.
Glad you like them!
Greatful for all doctors God bless you I had a stroke curious about the process 🙏
Great video again. Thank you.
Appreciate that! Thank you!
Thank you so much, this kind of stuff saves people lives in ICU
Glad you enjoyed it Christian!
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Hii. First thing. Thnkw soo much sir as crtical care technologist learn aloot of things through ur vides .. real mantor✨ Plz make some videos on FASTHUG BID and antibiotics /feeding cholries of icu patients thnkw if u consider my request..
Thank you millions of times🙏🏻
You're very welcome!
Thank you
This is one of your best videos
Thanks for that Jessica. Really glad you liked it!
Amazing .. plz make some videos on FASTHUG BID and antibiotics /feeding cholries of icu patient ..if u consider my request. Bundle of thankx .
thank you so much
You're welcome!
This is very comprehensive, usually when it come to intubations, ill use MALES mnemonic to prepare my self and the team.
M - meds
A - airway / bvm / opa
L - laryngoscope
E - ett / stylet
S - suctions
Nice, I like it!
Cool
Thanks!
Thank you so much!
Reminder that if a pt has been in trendelenberg post op there may be edema in that area that may be a problem if they crash and need to be reintubated.
Great video as always!! One thing I would add is, depending on hospital policy, restraints may be needed once the intubation is performed.
Yes, very true!
@@ICUAdvantage. Can I do it at my nursing school and it does connect to valve ambu bag. Do I have to squeeze 30 times per minute.and it also connects to the monitor.so if my patient needs to be hyperventilating.lung sounds. And I bring my stethoscope.🩺
Restraints? Why would the patient not be kept unconscious if they have been intubated if I were fortunate, or unfortunate enough to survive such an ordeal after being intubated, awake alert, and restrained,There would be some fucquing major code red going on between the providers who initiated that policy and myself
Crazy that we do all of that in the back of an ambulance. Equipment, meds, tube, vent. Cool to see how it goes in the hospital.
Yeah I have so much respect for y'all for doing so much of this stuff not in the "controlled" environment of the hospital! Hats off to you!
Wonderfull!
Many thanks!
We are discussing Ketamine for the sedative & analgesic with succinylcholine for the paralytic, have you seen that used?
Not to be dramatic, but I’m living my life for this videos 😂❤😂
Bought 2 t shirt to support us , from nurse Flower 🌺
Very interesting
Ty
Informative vidio
Can you please add more pictures in every slide
I try to include them when I think necessary. What else would you have wanted to see?
@@ICUAdvantage images of each equipment pls, along with the writings
Very advantageous.
Thank you!
Is this done to get more oxygen ? Or are ventilators used as they are very expensive and hospital and everyone gains from that ?
Would you do a critical care video on Nimbex?
Yes I’ve got it on the todo list!
When stated about inspiration and expiration and looking for change in color what exactly do you mean.... looking for blue to pink when having O2 vs. no O2? Slightly confused with color change on inspiration and expiration .... unless you meant watch for cyanosis to make sure there is a clear aerobic pathway ?
I think he was referring to the color change on the end-tidal co2 detector. It would be changing from purple to yellow.
excellent video bro. Jesus Saves!
Much appreciated
I’m assuming the bougie takes the place of the stylet?
Is this like a ventilator ?
What animation software do you use?
During Covid we had nurses who put in the ventilator tube wrong, it blew up the lungs as they were not told how to properly operate the thing…dead patients….
OFTEN? Use sedation/ analgesia??? Unless the exception is in patients who have crashed and are already unconscious, they better be premedicating this patient or things will get nasty should I survive this episode
Don't forget Blood gases in the room! Good video!
Good add!
@@ICUAdvantage.what should I do to operate the intubation?
Do you have to scan all the meds in before giving? Since it's emergency. Or can you do that after.
So this will depend on your hospital policy, but typically no. We double check with another RN and then give emergently then chart after. This is also why it’s important to have someone documenting during codes/emergencies.
Video laryngoscope! Wow! I've been out of the business for awhile.
They are quite cool and used frequently
Doesnt need to be flat!
Barring certain circumstances, the majority of my pre-hospital intubations are performed in approx 30 deg. head-up position.
Our patients are not fasted and are more likely to have just left the Chinese Buffet before badness happened.
Head-up helps promote diaphragmatic off-loading, increases functional reserve capacity, allows for alveolar recruitment, mitigates the aspiration risk, and contributes to promoting "safe(r)-apnea."
I've shown this method to in-hospital providers as well to overcome the height of the bed by utilizing the step stool often reserved for chest compressions. Watching providers immediately flatten the patients we have optimized before delivering them in = or > condition is maddening, particularly when followed by the predictable and thus preventable sequalae.
If it's inconvenient to lower the bed for the majority in the room, at least elevate the provider performing instrumentation. This isn't an attempt to broadside or offend in-hospital providers. We've learned this through reading your literature and correcting our previously incorrect approach.
The outcomes? Improved first pass success. Increased control of the team as the patients are less-likely to decompensate causing emotional responses like over bagging. Less risk of aspiration, decreased length of stay/cost of care. It just seems like a much better approach for the patient. My observations are anecdotal, but the differences I've observed have been real. Really wish people like you could shine a brighter light on this to make us all better.
Enjoyed your content and wish everyone here a successful 2023.
onlinelibrary.wiley.com/doi/full/10.1111/acem.13805
www.ingentaconnect.com/content/wk/ane/2016/00000122/00000004/art00021
EMTs don’t intubate, that’s a paramedic’s job. All paramedics can intubate, in certain localities RSI is a separate skill that they will need to be cleared to perform.
You talked for like 35 minutes and said nothing at the beginning of the video 😟😫😫😫
Black background and small sized words make the subject less understandable and impressive