“nobody makes the first jump”

11 Jun

This is what my anesthesia attending said to me following my first attempt at intubation on a live person, followed by, “You’ve seen The Matrix, right?”

Clearly, I was not exactly successful.  Everything seemed to go smoothly, except for my initial difficulty wedging open the mouth of a woman who was missing, or in the process of, most of her teeth.  Then we didn’t see her chest rise and fall with the next breath, and the end-tidal CO2 monitor didn’t record its characteristic wave with the next exhalation.

“And we’re in the esophagus.  Been there.”

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4 Responses to ““nobody makes the first jump””

  1. Eric Rosoff June 11, 2012 at 5:16 pm #

    the worst! I like to think that the more initial failed attempts, the more motivated you’ll be for mastery. So, you actually end up better than the guy who got lucky on the first try…

    • annaojesus June 11, 2012 at 5:21 pm #

      the worst now to be the best later…i like it! thanks buddy!

  2. johnbennett70 June 11, 2012 at 10:36 pm #

    Anna

    From working in the Emergency Room, medium load of patients, I have had my share of intubations. I can tell you, as most ER docs will, is that it is one of the most stressful
    time in my career as an ER doctor.

    Everyone is standing around the table looking at you, depending on you to get the damn tube in the right spot.

    Some are difficult, even for experienced ER docs, and I had my share. In a pinch, I would call other docs, was not that proud.

    If I had to do it again, I would spend more time in the OR with the anesthesiologists, getting to know the throat anatomy like the back of my hand, on someone that is knocked out. Most anethesiologits will do it gladly, ask them

    Like anything in medicine, practice, practice, practice, if you want to get good. You certainly cannot get good if you do it once every couple of months.

    jb md

    • annaojesus June 13, 2012 at 11:02 am #

      JB, thanks so much for the encouragement and advice. I really should talk with more anesthesiologists about the anatomy–that’s a great idea! And I can imagine that in the ED you must get all kinds of difficult airways, and it’s not like the patients are pre-oxygenated to give you time! Thanks again for your thoughtful comment–I appreciate it a great deal!

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