Frustration Nation...

[EM2013woot]

Title sums it up. I'm living in a glass case of emotion here, and it's chock full of frustration.

Here's the deal: I matched at my top choice program (and still feel grateful for this), a program with a lot of procedures. We interns are spread out over different pods and supposed to get most of these, and over the last 2 months many of my co-interns have gotten 4-7 intubations. Yet, I have 0 (I'm now the only intern who hasn't gotten a single tube)...because I have not had a single patient in my pod who needed to be intubated. Acuity is supposed to be spread out equally between all the pods, and over my last 3 shifts every pod has had at least 1 patient needing a tube...except mine. I'm happy for my colleagues, but it's getting so frustrating that I haven't been getting this experience.

I know this is due to luck...but holy effffff what a run of luck. I know there's far more to this job than sticking plastic down people's mouth-holes. However, I'm getting a bit concerned that my intubation skills aren't up to par with my co-interns, and when I do finally get a tube this will be noticed/frowned upon.

I don't like to complain and I don't want to appear as a whiner to my classmates...so I'm turning to the wonderful anonymity of the interwebs to vent. Anybody else experience anything like this? Any words of wisdom, stories of having no tubes and then getting 1000 in one shift, cute little memes, or general commiseration would be most welcome.

Seriously, if I have another shift where all the other interns working get to intubate except me...I might just have to tube myself.

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[Birdstrike]

Keep your cool. It's August year 1. Your EM career is in it's embryonic stages. Soon you'll have a run of 5 or 6 and the others will have a drought. By the end of 3 years it will even out. You won't even remember this in 5 years. You'll get your tubes.

 

[dotcb]

Chill out. Be patient.

 

[dchristismi]

At this point in my intern year, I hadn't actually set foot in the ED yet. And wouldn't for a couple more months. If this is the biggest problem in your life, count your blessings.

 

[EM4life]

Agree with others, you will have plenty of time to learn. There will be plenty of procedures that your co-residents will have not done that you have as well. There is no sure way to guarantee everyone gets the same skills at the same time, you just have to learn and practice them before you graduate.

You will get your black cloud some day

 

[DeadCactus]

The patients must be avoiding you because they heard about your lack of experience intubating. It's like how keeping your virginity too long eventually starts making it much harder to lose. No one wants to be the first to take a 30 year old man's tube down the throat...

 

[Akail]

Uh....really dude?

 

[Spinach Dip]

I might just have to tube myself.

There are videos on Youtube of people doing this. No. Really. I'm serious.

GL if you decide to try this (you'll need it!). And remember:laryngeospasm sucks.

 

[deuist]

There are videos on Youtube of people doing this. No. Really. I'm serious.

GL if you decide to try this (you'll need it!). And remember:laryngeospasm sucks.

I tried this with only cetacaine and could not pass the cords.

 

[Tiger26]

I do nasal fiberoptic all the time on myself to show the procedure to the residents but impossible once I get near the cords

 

[RustedFox]

You guys are masochists.

What's the trick/procedure for aerosolized lidocaine? Heard of it being done, never seen it, no desire to try it on myself.

 

[Dr Peper]

I do nasal fiberoptic all the time on myself to show the procedure to the residents but impossible once I get near the cords

That is freaking awesome. There should be more attendings willing to demonstrate on themselves.

 

[Hair Police]

That is freaking awesome. There should be more attendings willing to demonstrate on themselves.

The PD at Cincinnatti has interviewees use the scope on him during their interview day.

 

[Tiger26]

You guys are masochists.

What's the trick/procedure for aerosolized lidocaine? Heard of it being done, never seen it, no desire to try it on myself.

5 cc of 4% in a nebulizer. On myself, I do an atomizer and viscous lido though since its more Pyxis friendly.

I did a lecture on it during residency while performing the procedure

 

[WilcoWorld]

The PD at Cincinnatti has interviewees use the scope on him during their interview day.

Do you have first hand knowledge of this?

 

[EM2013woot]

I do nasal fiberoptic all the time on myself to show the procedure to the residents but impossible once I get near the cords

Wow, this is crazy (and impressive).


Also, thanks for all the comments (including the jabs). Today was my first day off in a while and it felt good to be outdoors and clear my head. I spent 5 hours at the beach and now I'm right as rain. The beach saves.

 

[DeadCactus]

Do you have first hand knowledge of this?

He has also had interviewees pace him before.

 

[deleted547339]

He has also had interviewees pace him before.

transcutaneous or transvenous? transcutaneous isn't impressing anybody....have him put his money where his mouth is.

 

[AlmostJesus]

I can take a airtraq without gagging, although I only ever can see the arytenoids or just the epiglottis. I have also done this with a McGrath. I have yet to try the tube though
You dont need no stinkin lidocaine, just go slow and steady until you get used to it.

Also, 2% Lidocaine in a nasal atomizer makes the nose numb enough to do nasal airways or suctioning without problems, although the badass factor goes up by ten if you do a nasal on yourself sans lido.

For those that have tried the tube on themselves, have you tried transmembrane lido? Ive seen people inject lido though the crycothyroid membrane and be able to intubate themselves.

 

[Hair Police]

Do you have first hand knowledge of this?

I *did* it. When I interviewed. Saw his cords and everything.

 

[nlax30]

http://www.youtube.com/watch?v=bDRTzmuwMnQ&sns=em

 

[KinesiologyNerd]

Doc where I was a scribe is able to intubate himself. He has no gag reflex. Wouldn't believe it if I hadn't seen it late one slow night.

 

[Spinach Dip]

Doc where I was a scribe is able to intubate himself. He has no gag reflex. Wouldn't believe it if I hadn't seen it late one slow night.

No gag reflex is one thing. Tons of people can claim that.

But being able to push a plastic tube past the cords and into the trachea is something else entirely.

 

[WilcoWorld]

I *did* it. When I interviewed. Saw his cords and everything.

Must've been a different PD when I interviewed.

 

[gimghoul]

The PD at Cincinnatti has interviewees use the scope on him during their interview day.

Not on my interview day, although I did have my foot in his armpit at one point.

 

[KinesiologyNerd]

No gag reflex is one thing. Tons of people can claim that.

But being able to push a plastic tube past the cords and into the trachea is something else entirely.

It was awe-inspiring.