intubation

[stretmediq]

She's a doctor so she can let go of the tube. I'm only a paramedic so I have to hold it till it's duct taped

[DrN1984ER]

Ahhhhhhhhhhhhhhhhhhhhhhhh .. I'm Pretty Sure She Shouldn't Have Taken Her Hands Or Scope Out And Off The Patients Mouth Without Securing Tube .. Let Someone Else Pull The Stylit .. You Dont Have to Do Everything !! In An O.R SETTING !!

[kawasakikx250ff]

just wonderin why she took her hand off the tube when it wasnt secured?

[glen68ify]

ahhhhhhhhhh..no ppe for the assistant

[MusicDr26]

Why is it that it looks like she's still conscious?

[noid2209]

I Want To Be Intubated!

[ahmedmostafakamal]

Too slow doctor

[CabezonGOW]

@ahmedmostafakamal

Too much House M.D. right?

[SherinaW]

I only wish I was qualified to do this procedure

[seycasjovencom]

todo mal

[bayoufrogg]

If you are concerned with the speed at which the anesthetist performed this intubation, then you do not understand the basic principles of anesthesia. She denitrogenized the lungs first, which gives her several minutes before an anesthetized, nonmoving, healthy patient will start to desaturate. If they desaturate before then, she would stop her procedure, give more oxygen with the mask, and wait until saturations are optimal for second attempt. Rushing = airway trauma, drama, and no success.

[Maximilus]

@bayoufrogg Truely thanks for your feedback. Is there a way to know or monitor when the patient is desaturated? How does she know the patient is truely denitrogenized or oxygenated while she's performing the intubation?

[dannjonnes]

@Maximilus Three minutes of tidal volume breathing of 100% oxygen is a good rule to ensure oxygenation. Also, eight deep breaths in 60 seconds is equivalent to breathing 100% oxygen for 3 minutes. [Miller, 2011]

[treckfirefighter]

NO ME PARECE LA TÉCNICA ES MUY MALA, DESDE LA FORMA DE COGER EL TUBO, HASTA SACAR LA GUÍA SIN INFLAR EN NEUMOTAPONADOR, EL HECHO DE QUE LO HAGA TODOS LOS DÍAS NO QUIERE DECIR QUE LO HAGA BIEN, ADEMAS ES UN ERROR MUY IMPORTANTE ACERCARSE A LA CARA Y APOYAR EL CODO. Y HABLO CON CONOCIMIENTO SOY ANESTESISTA DE TRAUMA E INTENSIVISTA

[doubleaaaron]

As long as your getting paid, what a piece of shit.

[docadai25]

Agree with longboardisgood! this is an elective sequence induction.....patient is well oxygenated....therefore she can take all the time in the world to tube the patient slowly! Welldone to the anaesthetist!

[Ronsola1]

It either goes in correctly or it doesn't. In my experience if I'm tubing someone then their basically f****d, or to put it another way, "WHO CARES AS LONG AS I'M GETTING PAID AT THE END OF THE MONTH". thank you and good night.

[adicia1]

Also a sniffing position isn't a very good term for thinking of how to position someone's head. Ear to sternum position is the best term for proper head position prior to intubation.

[adicia1]

In my experience a real person is more difficult to intubate than a training dummy. With the proper technique (chevalier jackson's sniffing position) most people are easy to intubate.

[adicia1]

That was good technique, but I don't like how the tube wasn't secured (she's obviously comfortable with it). I like that the pt has a pillow under her head, prior to intubation attempt. This is the best way to position a pt (emergency or not), except for c-spine precautions.

[mustanglover1985]

has anyone had this done if so are you awake during this process because it looks like her eyes are open

[kingbear3472]

@mustanglover1985 No she is not awake. They normally tape the eyes shut, because that sometimes happens.

[GrimeyTube]

I just learned how to do this in EMT class the other day. It looks like its easier on a live human than a dummy

[twilightfanedward199]

@GrimeyTube it looks so much harder on a dummy just watching the way they do it id rather do it on a real person lol

[SignorSchnitzel]

@twilightfanedward199 it is honestly harder to intubate a dummy haha unless your intubating a person with poor anatomy going against your favor..

[twilightfanedward199]

@SignorSchnitzel haha oh well

[toocna]

This pine was put in me too almost three months ago, seemingly, because I really can't remind doing this thing to me

[GsusChrist12]

HIPPA is for pussies hah

[drjctmd]

very confident, very fast.

[blackman4lyfe44]

1. why isn't the syringe attached to the tube, before you begin? @1:37

2. @1:37 that sounded like your Miller blade scrapped the top teeth of the patient. using those teeth as a fulcrum, are we?

3. The hand holding the tube should be wearing gloves. Infection Control nonexistant in your universe?

4. What year was this video taken? HIPPA also nonexistant in your part of the galaxy?

[Longboarderization]

@blackman4lyfe44 You better be no less than a perfect doctor or you can shut up ;)

[jsmed07]

Regardless of the pt's clinical status, how is this not a HIPPA violation? Did you obtain permission from the pt (or her family) to have her face displayed to over 1/2 a million viewers? I understand the educational value of doing this, HOWEVER, I am more concerned with your possible breach of pt privacy. If in fact you obtained consent, simply mention it in the notes above.

[delilahrock10777]

I may be wrong here but shouldn't the people handling the ET tube be wearing gloves?

[bmsalen]

aaaaaaaaaaaaaaaaaaaaaaaaaaaaaa­aaaaaaaah..ma quando cavolo lo leva il mandrino??????oh my goD!!!!!

[GastonFranquin1]

@MrViolentlyHappy

Every hospital in NY state I worked at RT intubates on the floors and ICUs, if heavy sedation/paralysis needed anesthesia would be called;; in the US because anesthesia charges/billing (remember corrupt healthcare system) anesthesia intubates all over the hospital to make a buck, while the RT does it for free or maybe gets a dollar or two extra per hour..anesthesia may charge $500 per intubation khmmm

[GastonFranquin1]

OR intubations are pretty EZ, drug'em up overoxygenate and place tube in..tube OK to let go as pt is out and inflated balloon protects it from moving as pt is out, on the floors where RTs and anesthesia intubate 'hard' cases where pt is trashing etc NEVER let go of tube and have at least 3 confirmatory techniques for ETT palcement not just auscultate..some minor mistakes here but nothing unusual for the OR

[pollux2007]

If i would be on youtube i´d sue their asses

[Kakabeblen]

The only thing I have to say is, why the hell didn't the nurse help? The laringoscope was supposed to be in the doctors hand a second after she stoped respirating the patient, and the tube was supposed to be ready too...

But nevertheless, nicely done.

[rumit99]

@jensen666 u must be a nurse

[cast390]

I just had my gall bladder out and this was done to me,of course i dont remember a thing.She looks dead so i guess i did to.When I woke up in recovery my throat was dry and scratchy like sand paper and i was dying of thurst.

[thegreatannihilator]

Took too long? Whacker.

[jakiepoopoo2010]

Studies are showing that pre-oxygenated patients in a GA situation (non-emergent) can remain healthy perfusion and 02 sats for times as high as 10 minutes. So 38 seconds is good.

[o0rxkxrox0o]

She only took ~35 seconds between bagging and hooking up the oxygen. That's not too long, even in an emergency situation.

But I do agree, they should never have let go of the tube.

[johnster1964]

Why do they leave her hair like that???

[bethy001]

those who say it took too long are probable thinking of intubation in an emergency setting where you want to get in there fast.

But they never should have let go of the tube, that has potential to cause sooo much damage....

[kevinpatrickfarley]

do you think you could have checked the light pre doing this

do you think you could put some tape on that tube

thanks

[obone01]

Are the eyelids usually taped down during surgery?

[eBiology]

@obone01 Yes, to prevent the eyes from drying out because lacrimal glands stop functioning properly when a patient is put under general anesthesia.

[brooklynlulu]

Is it common for someone to bleed at the mouth just after it is done? My Mother has just been intubated a few days ago and it seemed bad, she was struggling although her eyes were closed, but they kept saying, relax relax, made me a nervous wreck and blood was going through the tube. What would do this? The woman says, oh this is quite normal and I am thinking ?????????? I may seem dumb but I would love to hear from those are are knowledgeable and it would calm me greatly. Thanks

[youknowhow123]

The time taken was fine - those who say it was too long are morons who pretend to know what they are talking about

Although, she did make a couple of mistakes:

1) She didn't check the light was on

2) She let go

3) Used the patient as a table (not that bad but breaches respect...)

[freelilminja]

nice controlled intubation .... the methode of how the ETT whas handeled seemed clumsy ....

@longboardisgood , comming from a Paramedic is point i agree 100% with u moaning about time is only applicable when the pre_oxygentaion was not spot on and "crash itubation"

[vvkool]

The patient was anesthetized and had a muscle relaxant. This was a completely normal and standard intubation in a patient with a normal airway. There was no signifcant delay. For those that say slow, have no idea what they are talking about.

Patients saturations will be monitored, but if healthy most patients ventilated with 100% Oxygen as here will maintain good oxygenation for 5 minutes or longer.

Letting go of the tube is acceptable unless the intubation has been difficult to achieve

[danielharris1991]

i will never forget when they took me off a ventilator after a nose surgery and when i was waking up and regaining conciousness, it felt like someone had stuffed a pen in my mouth and breathing down it, but i fell back to sleep again because they put me back to sleep and on a breathing machine, cause i was taking longer than normal to wake up from the anesthetic

[Me6is]

is she awake and aware??? Lookslite that!

[islandluc]

She let go of ET tube. This doctor should go back to axle school

[apparently16]

You let go of the tube. You're never supposed to let go of the tube, dead or alive. It causes the ETT to deviate either up or down. Rookies.

[mrmikelace]

totally agree with Lukephil she took to long. Primarily because she didn't have intubation equipment withing reach and hadn't checked the functionality of teh laryngoscope before hand.

[jamaicangirl111]

This is horrible...does this lady know that she is being filmed??

[smgonz]

i think this patient has already expired!

[troppodude]

@smgonz - she has really good colour for a dead person, but agree her lack of movement is concerning. Perhaps she was paralyzed so the doctor could tube without the patient fighting back

[cornfed03]

@cygnusx555 you must really hate being wrong. no one ever taught you any manners :) ignorance is just not knowing any better and can be fixed by learning. stupid is just stupid. Which are you?

[cygnusx555]

@cornfed03 suck it bitch !

[cornfed03]

@cygnusx555 cant you type anything else? I tired of arguing with stupid. Ive had more intelligent arguments with rocks. At least then I can talk to myself.

[cygnusx555]

@cornfed03 bitch

[minileafe]

Great intubation she's using a miller blade on her lrygascope I can't spell it. She should hahe taped the tube or used a mouth price to hold it in place

[bmsalen]

..ma chi criminale intuba con tutto il mandrino??????????SUPERATE LE CORDE IL MANDRINO VA ESTRATTO...E IL LARINGOSCOPIO è L'ULTIMO A USCIRE..MARòòòòòòòòòòòòòòòòò CHE ROVINA

[Mazgaroth]

umm... ever heard of learning how to intubate with a stylet properly?

[beatinitup79]

where's the cricoid pressure?

[tubetime256]

The anesthesiologist seems good, but I don't like her much, as she is condescending and patronizing towards the patient. I know this because, I have seen the video before this one, which shows right when the patient is brought to the OR Room up until the beginning of this video. This video is from another website, in which you can actually see the entire process from consultation all the way up until the patient wakes up. I just can't remember the URL exactly.

[longboardisgood]

No rush to intubate if you are not in an emergency or full stomach situation. When the patient is well oxygenated and is easy to ventilate, no need to go fast and risk to hurt teeth or vocal cords. Always easy to critisize behind a computer screen.

[jgrandison2004]

so much for checking the equipment before using it...''...where's the light...?" lol wow....

[superBrando555]

wmt ca intubate faster no offense

[blueeyez45]

Intubate too long. As long as its a women and shes doing it. intubate me, sedate me. love that part. women docs only. lay there, strapped down, masked and gloved doctor, sedate, intubate and sethsecope me. yess

[bobbypretzel]

@blueeyez45

Easy there buddy.

[chantellemg]

@blueeyez45 what the hell thats sick

[alena4dietrich]

I guess it wasn't for instruction - otherwise she would have:

- checked the laryngoskope before starting the intubation

- received the tube from an assisting while looking to the glottis

- safed the tube while blocking

- safed the tube while engaging the respirator

The only thing "beautiful" maybe was the dreams of the patient. Good luck.

[jasmine2g3]

She was slow!

[jzm3bsj]

all you people who criticise this woman..I bet you do not work as an anesthetist every day..she knows what she's doing and does good..

[Frankielovestea]

@jzm3bsj but she was really slow... like what happens if the patient woke up! like seriously think about that

[kingbear3472]

@jzm3bsj Most people may criticize this lady are medics in the field. We learn this skill for emergency/uncontrolled settings. There are a lot of things that she did different with this skill that would get us in a heap of S@*%.

[longballkid86]

next time, why dont you make sure the blade is corectly attached and the light is "bright, white and tight".

[skinbulle]

oh my good!!!

[sdazulkrema]

OMG THIS IS WHAT RESPIRATORY THEREAPISTS DO??? I DONT THINK I WANNA BECOME ONE NO MORE...........

[theerealrocknrolla]

WOW! This was horrible! I don't know where to start. You never take you hand off the tube until it is secured... she was so sloppy. She should totally get her license revoked. I'd be totally embarrassed to have this video up.

[jefty4]

wheres the ezcap?

[siednarb]

those eyes should have been taped prior to induction and intubation - that's how corneal irritations occur!

[IckyThump88]

öhm. das video in youtube.. ich hoffe die Patientin hat zugestimmt, andernfalls kann sie Sie verklagen xD

[aswan1234567890]

Did the patient feel any pain during the intubation process?

[WundertGarNichtsMehr]

@aswan1234567890

probably not.Though there is pain, she cannot "feel" it, since the central nerval system is blocked vy the anaesthetic.

[Afronegroderevo]

Пипец,меня бы за такую интубацию уже повесили...

[emtguy2202]

she's sedated, the cranial nerves of the face stop sending impules to all of the muscles so the eyes natural tendancy is to remain open. This is why recently deceased pass away with their eyes open.

[123BeautyQueen321]

she should be sleeping, right?? i thought people are "sleeping" while getting intubated.

[blueeyez45]

Eyes? Any women doc could sedate me, and intubate me while I lay there on re gurney sedated and half nude. Anyday

[gearhead91686]

if we are putting a tube in someone the LAST thing i am going to be concerned about is her eyes!!!!

[amihalyi08]

Shouldn't the doctor make sure that the eyes are closed? Did this doctor ever heard of corneal abrasion? Crying shame to post a video like this, I would sue the hospital if I would be the patient :@

[blackplastic7]

You don't know much about medicine do you...

[jzm3bsj]

@amihalyi08

I'm an anaesthetist, and when you have just given someone a general anaesthetic and stopped their breathing, your FIRST priority is to get an ET tube or LMA down so you can breathe for them. It is after we have dealt with that minor issue do we then concentrate on taping the eyes shut!!

[blueeyez45]

Any female doctor could sedate me, intubate me and sedate me any day, women doin that is a ohh yeahhh,

[Dman2325]

gtz831 your a scared rookie idiot

[addamrocks2006]

Until she told me that i was going to have a tube in my mouth to be monetered for breathing. My surgery did not take all day it was fast.

[addamrocks2006]

My anistishiologist was a female who put me to sleep for surgery in 2005, waited patiently for me to fall asleep. i believe it took a minute and half to fall fall asleep. i remembered having something in my mouth.

[blueeyez45]

who cares intubate me

[gtz831]

what the hell...... the helpers arent wearing gloves and she didnt even connect the co2 detector to the tube....thats against hippa!!!

[ewwade]

Ok first things first HIPPA (Health Insurance Portability and Accountability Act) has ABSOLUTELY NOTHING to do with medical technique. and to be perfectly honest the helpers are not required to wear gloves when doing casualcontact. (albeit in their best interest since it is an intubation and if the patient isn't adequately sedated they can cough up lung secretions if the balloon isn't inflated or they are in the way of the tube. the only thing you got right in your comment is the CO2 detector.

[ColinMeloy91]

@ewwade oh. never knew that thanks.

[2704heatherwolf]

thats because he got the two terms mixed up their is a difference between HIPPA and HIPAA

[ColinMeloy91]

@2704heatherwolf og yeah one's the laws thing and the other is the I can't share your information rite?

[2704heatherwolf]

(1) HIPPA is a Law... actually... that is intented for privacy of a patient.....(as a medical provider myself this HIPPA law is drilled into your head.) Patient privacy ...! the HIPPA LAW Helps with it. if a patients privacy is ever talked about without the patient permisson the medical personel can get in a crap load of trouble.

(2)HIPAA ....as you where refiering to is Health Insurance Portability and Accountability Act.........

[aaaaaaaaaa8892]

@gtz831

You dont use colorimetry CO2 detectors when your connecting to a vent in ER, there end tidal co2 monitors that not only tell you when she is expiring but also the concentration of co2, o2, and volatile anesthetic in her breaths.

[aaaaaaaaaa8892]

@gtz831

correction in the OR, in the ER you would prob use them...

[ColinMeloy91]

OMG her eyes are open. eek.

[emyzfederer]

was she dead already?

[NAIFgodfather]

@emyzfederer

No she's unconscious

[Coupeflyer]

58 Seconds before breath sounds are confirmed? To long if tube needs adjustment.

[TheMedic07]

Is 38 seconds consider to long for surgery?

[lukephil70]

she took too long to intubate

[jzm3bsj]

@lukephil70

No she didn't

[altaltalt123]

@lukephil70 Yeah but I guess it's for instructional purposes?

[Engine8medic]

@lukephil70 Not at all!!!.. well oxygenated patients like this can maintain great oxygen levels for quite a while....

[TOUCANBURT]

@lukephil70 The whole video is only 1:37 what the hell are you talking about?

[stunned69]

thanks for putting it up .Appreciated .

greetings ....

An italian anesthesiologist and intensive care ph

[blueeyez45]

INTUBATE ME

[blueeyez45]

Concious Or Awake Being intubated on a gurney by a women doctor what a rush. Laying there strapped down, meanwhile a doctor injects you with a medicince to sedate you, laying there you cant move butu ca breathe a little then you feel urself fall downa dn you are paralyzed and sedated. she sticks the tueb down u and inflates it and u have no choice and cant breathe so u lay there sedated and intubated. she listens to ur heart with her scope aginst you.

[war3gamer]

What a retarded comment + full of spelling mistakes.

[tpvalley]

my friend was intubated when concious, he couldnt move, but could hear and see it all, they were about to start cutting but just when panick set in.....he woke up in recovery!! thank fuck for that!

I read of some doctor rupturing someones wind pipe once?

[blueeyez45]

this doctor could breath for me as i lay there seadted going under while she intubates me, lay there paralyzed and cant move then she can listen to my hear her sethescope ohh yeahh i love that

[felipecarrasco0123]

pqp q coisa em...olha tirando os cabeçoes sem luvas entrando em contato direto com a mao na boca do pcte..oresto foi tudo blzinha.....

[blueeyez45]

Not paralyzed doesnt matter. I love this video. Being sedated on the table bu that doctor any day. sedated, intubated, paralyzed coudl do that nay day. intubate me doctor. and listen my heart with sethescope.

[Corbuzon]

granted but 99-100% sats aren't taking into account the CO2 buildup - have to admit to not having noticed the fogging though

[Corbuzon]

it was 45 seconds before the woman got a breath of air after the mask came off - very poor!!

[four4vizslas]

This patient was not paralyzed - the patient was breating on her own just at a slower rate which is evident by the fogging of the ETT.

If the patient was in respiratory arrest / fully paralyzed you would not see ANY fogging of the ETT untill you squeezed the bag; moreover, the fogging occurs on the EXHALE (so it is obvious the patient is breating slowly).

[blueeyez45]

Any er tech, nurse doc or in OR could intubate me women be bette rbut intubation ohh yeahh intubate me

[DrGaellon]

Um, ever heard of HIPAA? I hope you had a signed release from the patient allowing you make this video public...

[four4vizslas]

WE ALL KNOW H.I.P.P.A. Dr. Gaellon!

H I P P A stands for:

H- health care I- industry is

P- poorly

A- administered in

A- America

[ghspenn]

@DrGaellon maybe there was a signed release? you dont know that.

[sendittobryce]

@DrGaellon Oh please!!!!! Wow, you're a doctor.......so am I but I never introduce myself that way......I'm much more secure with myself.........Ummmmmm, yea, like they're dumb enough to post it on Youtube if they don't have permission........get a life!

[smugrinch]

@DrGaellon W/that moronic question, your credentials are now in doubt.

[ajauregui67]

damn like nothin sliped that in.

[razkal21]

Wow. I'm an ER Tech and this just went extremely smooth. Never seen it done without a hand...she did everything herself. No Cardiopulmonary Tech, ER Tech, Nurse. Well Done.

[bunde04]

nicely done..

[vickiormindyb]

I was intubated, but they did it through my neck and now I have a scar there.

I had an allergic reaction to something and stopped breathing.

The doctor said I had to be sustained through a tube inserted in my neck.

Anyone who wants to be intubated has never been intubated.

My throat was sore for 18 hours after I finally regained consciousness.

[PATCAT9]

Nothing like your patient saying "Lets Giver'" before you giver a tube!

Surprised she didn't spew after the first attempt.

Stylet should have been out after the chords.....

VG

[bunde04]

she didnt spew because she was dugged up on versed

[ewwade]

nah probally rocuronium and etomidate

[blueeyez45]

humdidiy15,

could you sedate me, paralyze me and intubate me please if you are a anthesologist doctor please, put your sethescope on me and listen to my chest with your gloves touching me too while i lay there sedated and cant move.

[humdiddy15]

Ah the good ol miller blade...I usually have a nurse pull the stylet as I advance the tube into the trachea...

[blueeyez45]

tape or no tape u need oxygen when going under or sedated. especially like this vid u layign there sedated cant move lady dotor intubationg you. couldnt u love that part or what expecially when she blows up the ballona nd ur intubated and she listens to ur heart with er glvoes on urchest

[tela11238]

she should have taped the eyes before intubating, she is due for a corneal abrasion!

[chucky613]

Some how they seem to think getting an airway is more important than taping the eyes shut....so stupid of them !...you can totaly die from corneal abrasion...it's not like you can die from lack of oxygen...they are soooooo stupid

[musicnarts22]

are you .. ike... dumb ? of course you can die from lack of oxygen. derrr

[chucky613]

ok there dumb ass !...i did this procedure a few times, and i know you can die from lack of O2...i was being ironic towards tela11238's comment.

[mill2mac3]

Actually corneal abrasions are one of the biggest reasons why anesthesiologist get sued. Many anesthesiologist do tape the eyes prior to insertion of the ETT. I usually take a few seconds to tape the eyes after I have established that I can ventilate while I am waiting for the NMB agent to kick in.

[humdiddy15]

I usually go across the eyelid after succs or roc is on board as to assure they are out..Tube them, secondary confirmation, vent and then tape they eyes shut...ABC's ABC's

[blueeyez45]

intubation from this womeb doc. sedate me paralyze me, intubate me paralyzed and sedated, then feel a ballon expand on my throat and then her scope listening to my heart and then the adventure beginsss

[blueeyez45]

surgical intubation ohhh yeahh ove this on me and this lady doc ohhh yeahh

[junestripes3]

what did she go under for

[happilylil]

i am taking Levodyn and it's really the best pill i've ever tried, no side effects and all natural.

[queleimporta2008]

pobrecitaaa!!!!T-T

[lsisk3]

Wow this was terrible, the one thing that they taught us in school. was to NEVER let go of the tube!! and btw what is wrong with using a straight blade on an adult? we were taught to use whatever was more confortable to us just as long as we got the tube in

[RINO2006]

ye i'm a student and saw the same mistakes as jafoems says. pitty.

[jafoems]

Several mistakes made here. Did not use the scissor technique, poor pre-oxygenating, check your equipment before use, prepare your equipment prior to intubation, never let go of the tube after tube placement, confirm placement by also listening to gastric sounds, and securing the tube would be nice. Please tell me this lady is a student.

please tell me the subject is just a manequin