NREMT skills sheet question

C

Chief Complaint

Forum Captain
429
1
0
Just going over my skills sheets for registry at the end of May and i found something that just doesnt make sense to me.

After ET intubation, the examiner will state that "you see secretions in the tube and hear gurgling sounds with the patient's exhalation".

It is a critical criteria to pre-oxygenate the patient PRIOR to suctioning the tube with a soft catheter. Wouldnt that cause the patient to aspirate the fluids? Wouldnt suctioning for a few seconds and then resuming ventilations make more sense?
 
8jimi8

8jimi8

CFRN
1,792
9
38
Chief Complaint said:
Just going over my skills sheets for registry at the end of May and i found something that just doesnt make sense to me.

After ET intubation, the examiner will state that "you see secretions in the tube and hear gurgling sounds with the patient's exhalation".

It is a critical criteria to pre-oxygenate the patient PRIOR to suctioning the tube with a soft catheter. Wouldnt that cause the patient to aspirate the fluids? Wouldnt suctioning for a few seconds and then resuming ventilations make more sense?
Click to expand...

You will be removing their oxygen from their lungs. When you bag a patient, you don't just squeeze it in there at 500mph. You bag gently and watch for ADEQUATE chest rise. Before you do anything with an advanced airway for national registry, you'd best just remember to preoxygenate. Miss your tube on fred the head? "i direct my partner to preoxygenate the patient" just as important as scene safety and BSI.
 
OP
OP
C

Chief Complaint

Forum Captain
429
1
0
Im not sure that im following what you are saying.

By pre-oxygenating a patient with secretions in the tube, arent i just forcing those secretions into the lungs? Why wouldnt i suction for <10 seconds and then resume ventilations? Clearly they will be deprived of oxygen during suction but isnt that better than forcing fluids into their lungs?
 
J

johnrsemt

Forum Deputy Chief
1,679
263
83
When you are hearing and seeing fluid in the tube; it is ALREADY in the lungs (unless the tube is in the esophagus {sp?}). So oxygenating isn't going to put more fluid into the lungs, and the patient needs the oxygen.
 
You must log in or register to reply here.
Top