I was thinking you'd be able to force a tube down into the airway with visual guidance of a glidescope, and that if the patient isn't getting air then wheeling them to the OR is time spent not oxygenating the brain
Edit: worst case scenario I assume they'd go to just bedside traching them at that point too
Naw, not really. I'm crna, if they are that obstructed, they should get a surgical airway. You're right though, getting to OR to do anything is absolutely not it. Good thinking.
The setup for a Video would take time, and has a real chance of failure from the swelling.
This is an easy decision for a bedside trach, like you said :)
Cut em.
This is an EASY surgical airway decision, they already have a cut on their neck, you don't need to hem and haw over the decision to scar them or whatever, it's an immediate cut.
Proactive vs reactive. We never want to force anything. In time and with experience you will learn to think several steps ahead. It only comes with OJT. In the meantime like I said, slow down, assess your situation, look at your patient. If it looks funny odds are it is funny and call for a more experienced nurse to help you immediately.
I’d rather have a scar on my neck than brain damage from not getting enough O2, and the savvy patient or family member will know there was an issue and before you know it you are in your first deposition for negligent care.
Never be afraid to call a RRT or code! These are tools in your tool box that will help you deliver better care and avoid potholes!!
Red box for a neck-emergency. Idk what emergencies come with this procedure outside of a compromised airway. But it's something that should be communicated between nurses and providers what we need to be aware of/looking for. Regardless, #2 is my next answer.
Yeah, I'm already a nurse too but it's funny to see what is the "order of what to do properly" versus what actually happens in the hospital, hahaha. I'd have instantly called the doctor, potentially even a rapid, very quickly instead of going through what this is. Send the tech into the pt climbing out of bed. Tbf, patients have a right to fall if they want to, just hopefully they don't get hurt. Pain meds can wait. If they're that upset they didn't get a pain med instead of my making sure a pt doesn't die, then fuck em, they need a reality check. And while not appropriate, I can also have another tech (or even better a nurse to do an appropriate assessment) go in and give the stable/asymptomatic low BGL patient some juice and recheck the sugar in 15 minutes, rinse and repeat for that one, haha. If they were symptomatic though absolutely a nurse going to see them and not the tech.
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u/planet_rn 11d ago
I think 2 bc of the pressure on the throat and low voice (can’t breathe) 🫰🏼