my OR clinicals

[VentMedic]

are there any other hospitals in your area that use ET's?

If you look for a hospital that does cardiac surgery, they will use ETTs since these patients will be on a ventilator once outside of the OR.

If you can shadow an ED doctor in a busy hospital, they will use ETTs since these patients will also be on a ventilator.

 

[sdchargersfan]

I had a hard time getting tubes in my clinical rotation as well. 10 tubes is a big requirement. We were only required to do 3, but I got lucky and had 6 in my internship. It sounds like you need to talk with your teacher or your clinical cordinator and tell them the issue that you are having, and maybe they can talk with the medical director or MD. LMAs are also great practice though, and I can see them replacing ETs in the near future.

 

[mikeN]

alright, update. I got my 10 tubes. I went to extra days to get them. I only missed one tube and I used a miller blade on that one. I missed a tube in the ER this morning on a woman that looked easy. She was anterior and her stomach contents kept coming up. A traumatic arrest came in today too and the doc was kind of mad the crew used an LMA instead of a tube. The doc tubes that guy due to messed up anatomy from the accident. I did get a bunch of med pushes on that one.
On an unrelated note, I swear I'm a black cloud for stuff.

 

[Ridryder911]

I had a hard time getting tubes in my clinical rotation as well. 10 tubes is a big requirement. We were only required to do 3, but I got lucky and had 6 in my internship. It sounds like you need to talk with your teacher or your clinical cordinator and tell them the issue that you are having, and maybe they can talk with the medical director or MD. LMAs are also great practice though, and I can see them replacing ETs in the near future.

Just to think, the new NHTSA scope/curriculum will require Paramedic students to achieve 5 live intubations. No exceptions.

R/r 911

 

[tydek07]

Just to think, the new NHTSA scope/curriculum will require Paramedic students to achieve 5 live intubations. No exceptions.

R/r 911

We had to have 10 successful live tubes in order to pass the class. From the looks of it, we had more requirements then some other services have for their paramedic program(s). I know that some have even higher requirements, but from what I have seen, a lot do not.

tydek07

 

[reaper]

Dang, I was required 30 live intubations, when I was in school. We were also required to have 100 iv sticks. I guess things are getting to easy, now a days!

 

[mikeN]

10 is challengin to get but not impossible. I would have like to do more and my teacher would like me to have some more. If I don't get a couple more in the ED my teacher is going to put me in another OR for a week. As for IV's. My requirement is 75 by the end of my clinicals and I have 73 and I'm no where near done. I sucked at them at first and now I can stick almost anyone in one or two shots. I will definatly have well over 200 by the time I'm done.

 

[paccookie]

OR clinicals were fun. We had to do 20 successful intubations. That seems to be high based on what the other schools in my state require (5 - which is the state minimum). By far the most useful experience was learning how to properly bag the patient. Don't pass up learning anything they are willing to teach you. Ask for tips and be ready to listen. Ask questions. I've done two field intubations since my OR rotation and that experience has been very valuable.

 

[NESDMEDIC]

I was required to have 15 adult, 15 child and 15 infant live intubations.

 

[fma08]

Dang, I was required 30 live intubations, when I was in school. We were also required to have 100 iv sticks. I guess things are getting to easy, now a days!

Would have been nice. From the sound of it when I started school, it seemed like some people were going through school without having to perform even 1 live intubation... Something wrong there in my opinion...<_<

 

[medic417]

Maybe Vent can post how many CRNA's are required before they are turned loose. Would bet we don't even come close yet we are working alone while they have doctors, etc around if things go bad.

 

[VentMedic]

Maybe Vent can post how many CRNA's are required before they are turned loose. Would bet we don't even come close yet we are working alone while they have doctors, etc around if things go bad.

We don't use many CRNAs at my hospital so I'll have to get back to you on that. Considering the length of the program and the intensity of their clinicals, I wouldn't even want to guess because it may come up short.

For RRTs, the programs can average 1-5 for adults, 1-5 for kids and 1-5 for infants. Once hired at a hospital where RRTs intubate, another 10 - 20 may be required depending on the area you are working in and may need to maintain 10 - 20+ per year. For L&D, it is preferred you have no less than 25 per year (preferably more) since meconium babies require that you do not miss with each pass of the tube. For specialty teams, you need at least 100 intubations for the age group the team specializes in before being allowed to apply for the team. If you are on both a Neo and Pedi team, you will need to meet the proficiency requirements in both. RNs may also intubate on these teams and are expected to get at least 10 intubations during their training once they are accepted on the team and maintain competency throughout their time with the team. For transport we will probably not have doctors around and may be 100s or 1000s of miles from home in the middle of nowhere.

At some hospitals, if an RRT has 3 patients in a quarter where it takes you 2 or more tries, you may be told to work under supervision for the next 5 - 10 intubations.

 

[Ridryder911]

Maybe Vent can post how many CRNA's are required before they are turned loose. Would bet we don't even come close yet we are working alone while they have doctors, etc around if things go bad.

Most nurse anesthetist programs are at the minimum of two years graduate to closer of three years. I know it varies from program to program as well as most hospitals that do use them as a sole provider they have privileges similar to physicians. Most do clinical/fellowship for years usually all year long (M-Fri or more). That is why many have a stipend for those in the program. For those that are under an anesthesiologist, many have to still have the physician present when placing the patient under and intubating them; even decades later.

 

[VentMedic]

Most nurse anesthetist programs are at the minimum of two years graduate to closer of three years. I know it varies from program to program as well as most hospitals that do use them as a sole provider they have privileges similar to physicians. Most do clinical/fellowship for years usually all year long (M-Fri or more). That is why many have a stipend for those in the program. For those that are under an anesthesiologist, many have to still have the physician present when placing the patient under and intubating them; even decades later.

But the physician presence is during clinicals while still in training, correct?

I know once they get their CRNA, they can be in the OR without an anesthesiologist.

That is not much different than the residents having a higher level resident, fellow or attending at their side. Or, in the case of our residents, they may get an RRT beside them to take over after two attempts.

 

[Sasha]

Would have been nice. From the sound of it when I started school, it seemed like some people were going through school without having to perform even 1 live intubation... Something wrong there in my opinion...<_<

The two other students in my class never got a live intubation. Very wrong! That's not a skill you wanna be trying for the first time for real all by yourself.