Adult Intubation Skill

[RedneckHunter004]

was good except he failed if he was doing this for national registry... he didnt inflate cuff to make sure it inflated before putting in pt and he also said suction for 15 secs. well thats a fail its 10 seconds

[jeremyzachmann]

you forgot to check your cuffs prior to insertion. Besides that, Solid. 

[brandiga03]

great video!

[jasonwassom]

an OPA is an "Oropharyngeal Airway"....or basically...it's a piece of curved, thick plastic that goes into the mouth "oral or Oro"...and it prevents the tongue from falling back onto the pharynx "Pharengeal"...therefore keeping the "airway" open so that we can circulate air. For short we just call it the OPA.

[minileafe]

Great intubaton what is an opa

[jasonwassom]

@minileafe - an OPA is an "Oropharyngeal Airway"....or basically...it's a piece of curved, thick plastic that goes into the mouth "oral or Oro"...and it prevents the tongue from falling back onto the pharynx "Pharengeal"...therefore keeping the "airway" open so that we can circulate air. For short we just call it the OPA.

[cedriclee11]

wow amazing i hope im this good one day

[lafire444]

great job bro!

[Stormwind101]

Jason, great instruction. Thanks for posting. Very Helpful for those of us just starting out.

[Brad8350]

perfect intubation actually, anyone talking about checking a pulse has obviously never taken any skills tests and is out of touch with the EMS field. look listen and feel gave him what he needed doesnt matter if the heart is beating when there is no airway. Nothing but PPE's and ABC's!

[jasonwassom]

The skill being performed is intubation. Once that becomes obvious to you, you'll understand why "checking for a pulse" doesn't really matter for this short teaching and practice video. I appreciate your attempt to pick this apart, but it's not really necessary. thanks for commenting.

[Dragill]

Unfortunately you didn't check for a pulse, and the patient was actually in cardiac arrest, not respiratory arrest. Whoopsies.

[DrSkawman]

@Dragill lol....very good point....

[laurems1]

Why don't any of these videos ever include the CC's needed to inflate the cuff - even the instructional videos omit this one rather important detail.

[jasonwassom]

@laurems1 - Hi there...it's typically 10cc's. Thanks.

[laurems1]

@jasonwassom - Thank you for the info - now I need to keep it all straight - dual lumen, King's , and E.T.

[cygnusx555]

@laurems1 maximum inflation is 10 cc's anymore could cause severe consequences to pt recovery. If you need more then 10 cc's to form a seal then your selection of ETT is too small.

[DrSkawman]

@laurems1 I suppose this is due the fact that tube's cuff may vary with size, tube kind, tube's brand.... You should always check CC needed, on the tube's package and verify cuff's integrity before using it on patient.

[Medicalphile]

Is seems as if your partner is bagging him too fast, it would cause hyperventilation.

[jasonwassom]

@Medicalphile - you are correct, he was bagging too fast. We were students at the time we filmed this, and he didn't understand what he was doing yet. thanks for commenting.

[mediaambient]

BSI SCENE SAFE!!!!!!!!!! LoL SOoo many ppl in my class missed that :P

[xxcanoxx]

What a terrible bagger...

[1987Challenger3]

also dont let the patients teeth get in the way. kick those out if you need to and use a hard stabbing motion when inserting the airway

[whiterook626]

Awsome job guys!

[johnny102marvin]

This guy is confident and you can tell he really knows his stuff. I would trust him in airway management care.

[farmonthefreeway]

LOL you didnt finish your ABC's. You did A and B, not C. And just for the record your partner was ventilating MUCH faster that 20x minute.

[MARINOfutureRT]

@farmonthefreeway I was just thinking that...

[McSqueebie]

200% HAHA. Funny.

[tpvalley]

I use a hammer just incase the tonsils get in the way, then use my foor to stamp it all the way in and keep patient sedated with a kicking motion......

[MrDerecksteven]

Great video thanks for shareing.

[wakeoforion999]

that poor mannequin is getting preoxygenated at like 100 a minute

[betteroffsolo]

200% oxygen??? LOL I don't think so.

[jpcjedi9]

I think he said "high flow o2, hundred percent oxygen". This guy is way excited about this, which i love. overall pretty solid method, he's definitely got his stuff down.

[jamacazord]

I agree with the guy below me. Besides the partner hyperventilating the patient, this was an excellent demostration.

[REspinoRN]

nicely done dude. =)

[psychocloud]

You never considered additional resources lol jk. Nicely done dude. Way to verbalize everything. You didn't let go of the tube until it was secured so again, great job!

[2100km]

Using the pinky to estimate tube size. Very nice. I've never heard of that.

I like the fact that you used the term "Pre-Oxygenate" instead of hyperventilate.

Very well done.

[aysoreferee459]

Really? That is in my EMT-B book.

[2100km]

That's good. Your state probably has a more advanced EMS system than mine. Are you saying the pinky thing was in your EMT-B book or the term "Pre-Oxygenate?"

I still hear a lot of people that should know better say "hyperventilate."

[aysoreferee459]

Both of them are.

[drmtantawy]

nice video, well done

[satinskyent]

Please get instruments

[durac9595]

dudes got an etco2 of like 3 at this point

[Gmo123451]

u want to hyperventilate immediately prior to intubation, once tube is in only need to breathe 8-10 times a minute

[lfndz88]

HYPEROXYGENATE my friend. not hyperventilation

[psychocloud]

PREOXYGENATE!

[mocitymyhood]

Cool video bro... Good job... Peace

[awaasi]

nice video, thanks..

[WhatToFear]

V. interesting, nice demo

[LukeLukeSlomka]

i like it well done

[Jordania301]

Great job intubator. Dude on the BVM needs to settle down a bit. I'd like to see an end tidal Co2 reading on that patient after that vigorous of a bag job.

[mangoomuffin]

Dumm Ass Red Neck!!

[hardpact07]

plus one

[FirebirdBuco]

damn dude great video...you kno your shit

[nineinchranger]

didn't he mean light bright and tight?

[Marty32]

I dont see BSI =P

nice vid =)

[mill2mac3]

Few more things 1. use of cricoid pressure 2. Avoid hyperventilation causing gastric distention, regurgitation & aspiration 3. Suction- should be available ASAP particularly prior to DL (not at the end). People can vomit once mask ventilation starts so be prepared with suction. 4. Head position prior to DL if concern for neck injury-might need inline stabilization. 5. false negatives on CO2-no cardiac output. Crap in the endotracheal tube. False positives-tube in the stomach & pt had a soda.

[LovinMyPrincess911]

Hyerventilate at for at least 30 seconds prior to intubation to make up for loss of O2 while tubing.

[firemedicpuppies]

hyperoxygenate ;)

[mill2mac3]

Uh-no, that is pre-oxygenation. To review the difference between ventilation and oxygenation (via extremes) you can use 100% and in as little as four large breaths, remove the nitrogen and pre-ox them. You can hyperventilate with a hypoxic mixture, remove CO2 (ventilation) and do nothing to raise their PaO2 levels (oxygenation). Hyperventilation can lead to aspiration. If they are awake and breathing pre-ox them. If they are not breathing, careful ventilation if pt hasn't been NPO.

[crisb82]

he is not preoxigenationing very well. if the pacient has a full stomach you have to oxigenate with slow and small volumes because it can regurgitate. i do that in perforated ulcer that come as an emergency. my mentor told me that and he is the best.

[Djuggz]

Great video explanation! I hope to get my hands on a dummy like that for practice.

[1992peter]

ME TOO!!!!!!!!!

[Shoudy101]

Thanks Man =)

[1992peter]

Where is some pulse oximetry?

Bagging WAY TOO FAST!!

Where is some ECG?

[GauleitervonBerlin]

Bagging too fast ? You anything learned ? hyperoxygenating ? ever hear it ?

[1992peter]

All the time.

Ever heard of HFOV?

High Frequency Oscillatory Ventilator?

[cartozian1638]

hfov is a little different, he is just ensuring proper oxygenation before the intubation.

[ares00006]

ur friend is bagging way too fast

[waycasy]

he is hyperoxygenating to the high end of normal prior to intubation.

[psychocloud]

High end of normal is 20 per minute. Hes bagging of a rate of like 40!

[ares00006]

ur friends is bagging way too fast

[waycasy]

he is hyperoxygenating to the high end of normal prior to intubation.

[ares00006]

ur partner is bagging way too fast.

[ares00006]

ur partner is bagging way too fast

[waycasy]

nice shoes on the airway man.

[myth272005]

Thanks very much for posting. It will help a lot for us who wants to take ACLS. Hope you will post more about ACLS. God Bless!!