Are you CPR/AED certified?

[FirNaTine]

Certified, qualified, and extensively experienced.

I'll say though, most of my out of hospital saves, had bystander CPR in progress when I arrived.

Without that, most likely would not have made it, or not walked out of the hospital without deficits as several have.

Learn it, you really can save a life. I've seen it! (And maybe throw a tourniquet in your car also if you will learn how to use it PROPERLY. France has been way ahead of us with those.)

<-17 yrs Fire/EMS last half as a Paramedic

 

[SirStev0]

BLS/ACLS/PALS

But I also cut people open for a living.

 

[SirStev0]

The cric was done after putzing with the tube several times. Some docs recognize right away they will not be successful and call preemptively, some don't. This one didn't. I've seen one not make it after the er doc consciously sedated and paralyzed them and then were not able tube after trying many times. Anesthesia was never called.

Is it pride that prevents them from calling anesthesia? They come right away when paged...

I realize they just don't do them as often. But it bothers me sometimes when they have the options: fiber optic, lma, page anesthesia. But don't

im not trying to make it out that it happens every day. When it does, it is traumatizing

Maybe er docs should have to take 1 day out of every month to tube all the pre op patients to practice?

The ER residents here do like 2 months of anesthesia. And our ER docs often throw in tubes. Crit Care/Intensivists too.
We're a Level 1 Trauma center though.

Out in bumblefuck it may be different. Some of the hospitals around us with limited surgery have only 1-3 staff Anesthesia docs and like 5-6 CRNA's. They aren't there on weekends/nights. Sometimes is cric or die.
And my time on Surg/Trauma ICU I've seen 4 brain dead people from cheater tubes from the field or small ER's. One I know 100% that a cric would have saved their brain. Anoxic brain injuries aren't cool and its a bitch to keep them from dieing. Not to mention quality of life is nil.

 

[TheVrolok]

BLS/ACLS/PALS

But I also play with penis for a living.

I jest, I jest. Sorta. Hope all is well brother.

 

[John Connor]

Considering what they're capable of doing for someone, it doesn't seem that expensive.

Yeah, but it's a crime to charge (no pun intended) that much to save someone's life.

 

[Grooveriding]

The cric was done after putzing with the tube several times. Some docs recognize right away they will not be successful and call preemptively, some don't. This one didn't. I've seen one not make it after the er doc consciously sedated and paralyzed them and then were not able tube after trying many times. Anesthesia was never called.

Is it pride that prevents them from calling anesthesia? They come right away when paged...

I realize they just don't do them as often. But it bothers me sometimes when they have the options: fiber optic, lma, page anesthesia. But don't

im not trying to make it out that it happens every day. When it does, it is traumatizing

Maybe er docs should have to take 1 day out of every month to tube all the pre op patients to practice?

I'm not sure where you saw this, but in my experience with a large city ER, the ER is under a lot of pressure and still perform admirably. People have this impression that medicine is an exact science with clear black/white solutions to every presentation, it is not.

I spent some time rotating through the ER in two of the hospitals here in downtown TO early on and was left with nothing but the highest admiration for the work the ER staff does. Not just the physicians, but the nurses, paramedics and everyone else involved. It is high stress, highly emotional in many instances and you have to deal with tough choices under pressure and immediate time constraints. The reality is it won't be gotten right every time, sometimes there is not enough time and you have to make the best reasonable choice with what you know at the time.

Every one of them understands that people's lives are on the line in these situations and they are not just winging it and hoping for the best, but doing the best they can with what information they have on hand when they need to act immediately.

After seeing what the ER entailed I knew immediately that I didn't want to be there and another route was what I would be going with. I'd much rather review imaging and do my reports than be under the sort of pressure they are in 12+ hours a day. In a large city you are dealing with continual triage, for example - having to quickly determine if the patient with the abdominal pain is yet another hypochondriac for the day with indigestion or suffering an aortic dissection.

 

[brainhulk]

I get they are under a lot of pressure, they are outstanding 99.9% of the time. Ok, yeah I'm picking on them for the sake of conversation (i do that often). I still find it odd they are not as proficient as anesthesia in this critical maneuver. If they lack training and practice, going to get it would be the prudent thing to do

They have a fiber optic camera for difficult airways in their bag, but they admit none of them know how to use it

it's liking having specialized pilots, one for take off and cruising...and then a separate one for landing. Except the landing pilot is always sleeping in the anesthesia lounge

 

[TheVrolok]

Germane to the conversation at hand, I just got home from work having witnessed both a CRNA and an anesthesiologist miss a tube each. On the second try the anesthesiologist got it. Shrug.

 

[Brainonska511]

I used to be, back when I was in high school (they had lifeguard training, so I was had Red Cross certification for lifeguard and first aid, CPR, and AED), but it all eventually lapsed.

 

[GasX]

Germane to the conversation at hand, I just got home from work having witnessed both a CRNA and an anesthesiologist miss a tube each. On the second try the anesthesiologist got it. Shrug.

Obese patient with a fat neck, small chin and no teeth?

 

[TheVrolok]

Obese patient with a fat neck, small chin and no teeth?

'course. It is essentially the standard population.