Practice Makes Persons More Comfortable

 

Ok, so today was my last day with the pedis (pronounced pee-dees, meaning pediatric patients).  I got in 6 more intubations, three of which were on the teeny pedis:  A 1, 4 and 6 month old.  My other 3 were on a 3 year old who swallowed a penny that got stuck, and two 15 year olds, one with appendicitis and the other having some hardware removed from a childhood surgery.

The first 3 surgeries were on the infants.  Considering my experience yesterday, I was on hightened apprehension when I was first handed the "blade."  I had already been "breathing" for the patient by keeping an open airway and ventilating them with an  airbag.  As I grabbed the blade and gently eased the head back, I had the attending talking me through the steps:  "head back, sweep the tongue, find the epiglottis, lift to the corner, visualize the cords, insert the tube."

I didn't initially see the vocal cords, but then I lifted (with the attending holding my hand and showing me how much pressure I could exert) again and there were the cords.  I slid the endotracheal tube in, put the ventilator back on, and the attending listened and confirmed placement.  "Whew!"  I think that's when I finally took a breath again.

We discussed the fine tuning of my technique, and the next two intubations went more smoothly.  One had some slightly difficult anatomy, and I initially intubated the esophagus, but that was quickly remedied, and I successfully intubated the trachea on the second pass.  The 4 year old was much easier since I had done all the 3 - 6 year olds on Monday.  Of course, the 15 year olds were the easiest since they were more like adults, and I had already done a number of those in the Emergency Room.

So, now I have the weekend free.  My dress arrived safely in Southern California, and there's one less thing to worry about.  Now if I can just get those darn programs and favors finished...

As for the pic today:  on D's (This and that, and hockey) advice, I invested in Paint Shop Pro and am playing with the program.  We'll see what I can come up with.

Tags: pediatric intubation, Miller blade, endotracheal tube, Paint Shop Pro