Talking during induction

[nimbus]

Had the circulator who was helping me induce signout out to another RN while I was intubating. I wouldn’t have minded, except it was a tricky airway and I had failed DL twice and it was started to get slightly stressful especially since mask ventilation wasn’t that great. I usually don’t mind a little chit chat or whatnot, but felt this was pretty inappropriate for patient care and very disrespectful of my job.

You are the first person in the history of SDN anesthesia who has failed DL twice

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[Simba1711]

When I was in residency the nurses thought it was a good idea to put extra blankets over my ett tube while I’m inducing and about to intubate. More important to make sure the patients not cold than secure the airway.

 

[Anesthesia_Guy]

Sounds like you're a lightweight at epidurals. I put them in too fast to allow myself to be bothered by those dumb things.

Same hear. As soon as those ho's start blathering away I'm like "brain - off" and am all business. I'm in and out of there faster than a surgery attending doing post op rounds.

 

[Planktonmd]

I invite you to where I am, you will get wide variety of knowledge, gossip while inducing the patient. I sometime shout and yell. I have zero tolerance to clucking of the staff around. It happens often.
To be honest, I thought guys you have special room for induction !

An induction room is a British concept, here in the U.S. anesthesiologists induce anesthesia in the OR.

 

[PpfSuxTube]

If I'm doing a tamponade or something like that I'll generally ask for a bit of silence. If i remember.Any else, na, who cares? It's all the same anyways...

The guys who need x,y or z condition to do their job generally are the ones I'd steer clear of...
Anesthesia is pretty simple like

 

[PpfSuxTube]

Sounds like you're a lightweight at epidurals. I put them in too fast to allow myself to be bothered by those dumb things.

A med student trolling staff... by god

 

[dabears505]

This bothers me much more when I'm placing an epidural. I feel like I am annoyed with 90% of the things the RN tells the patient about the epidural.

Example: "This first numbing medicine is the WORST part!! It will be like a big bee sting and hurt a lot, but it's SOOO worth it!"

I feel like that makes them so much more jumpy and dramatic, but when I say, "This is going to feel like a little mosquito bite," they usually don't even flinch or anything.

Also, "You'll feel so much in 5 minutes" on the patient whose BMI is >50, setting the patient up to be frustrated if it's difficult at all.

The nurses where I work frequently tell the patients the setting up is the longest part and numbing part is the worst. One time it took me forever to get the epidural, patient said nurse said usually setup is longer. I told her set up normally is 45 minutes, but I'm just very fast at setting up.

 

[sakata8242]

Light conversation I'm ok with, provided the case isn't an emergency or difficult airway. Unfortunately, some people are incapable of reading the room and are completely oblivious even when the pulse ox rapidly starts dropping.

What I can't stand is when OR staff and surgeons start literally shouting over each other because there are 5 different non-patient related conversations going on, the scrub is throwing instruments down on the Mayo in an attempt to make as much noise as possible, and the surgeon brings in his entourage of foreign visitors who are there to observe and take up space who then start talking amongst themselves in a foreign language. Meanwhile I'm trying to tell patient what I'm about to do and what I need them to do during pre-oxygenation and the circulator decides now is the time to start petting the patient's arm and asking if they want another blanket. Hopefully the Versed does its job because I can't imagine what it would be like as a patient who is medically illiterate and has to experience the locker room environment that the room devolves into.

 

[kidthor]

Light conversation I'm ok with, provided the case isn't an emergency or difficult airway. Unfortunately, some people are incapable of reading the room and are completely oblivious even when the pulse ox rapidly starts dropping.

What I can't stand is when OR staff and surgeons start literally shouting over each other because there are 5 different non-patient related conversations going on, the scrub is throwing instruments down on the Mayo in an attempt to make as much noise as possible, and the surgeon brings in his entourage of foreign visitors who are there to observe and take up space who then start talking amongst themselves in a foreign language. Meanwhile I'm trying to tell patient what I'm about to do and what I need them to do during pre-oxygenation and the circulator decides now is the time to start petting the patient's arm and asking if they want another blanket. Hopefully the Versed does its job because I can't imagine what it would be like as a patient who is medically illiterate and has to experience the locker room environment that the room devolves into.

To sweeten the deal you need an EMT to come in right before you induce (and in full earshot of the patient) to tell you they’re there to “put in some tubes”.

 

[sakata8242]

Nice...I forgot about that!

 

[norski]

To sweeten the deal you need an EMT to come in right before you induce (and in full earshot of the patient) to tell you they’re there to “put in some tubes”.

That's a quick GTFO where I work.

 

[2Fast2Des]

That's a quick GTFO where I work.

At my place they had the paramedic students come through to "get some tubes," I didn't let the 1 or 2 try to sneak in when I was at the hospital, and I have a strong feeling none of my other colleagues bothered to let them do anything either, because we never saw them again after a couple weeks of them hanging around trying to tube and dash. One of my colleagues had one of the medic students knock out teeth and bruise up a lip on different patients. The only thing I did was just to tell them that they need to know how to be able to bag mask or put it in an LMA as getting a tube is not going to save anyone if they will struggle in the field. As much as I know they need to learn, not letting it happen on my license and slowing me way down when they just show up out of nowhere and expect it to be given to them. Also flashback to when I was an EMT in college, paramedics were total dickwads to us, so this lead me develop a strong dislike to them 😏

 

[pgg]

Maybe teach them the importance of mask ventilation and the use of basic adjuncts?

They show up to "get some tubes" because that's what they were told to do by their instructors, and they need some boxes checked to graduate. Not their fault that they don't know what's important. Seize the moment, break the cycle, teach them.

 

[Arch Guillotti]

Maybe teach them the importance of mask ventilation and the use of basic adjuncts?

They show up to "get some tubes" because that's what they were told to do by their instructors, and they need some boxes checked to graduate. Not their fault that they don't know what's important. Seize the moment, break the cycle, teach them.

It's a hassle and I don't think anyone likes it but I try to do it anyway. Some of my partners are real jerks about it and refuse - guess what then it is just more of a hassle I have to deal with. Every now and then you get a decent one. The key is to set the expectations beforehand so that there is none of this last-second crap happens.

 

[Dr. Rude]

The problem is that bag/mask ventilation is a harder skill to attain mild proficiency than intubation. It will require a higher n.

 

[DocVapor]

EMS students don't get to just appear in my rooms as we induce and get a tube. They get told that they are welcome to watch my rooms and make sure they are able to introduce themselves to the patient beforehand.

Then I teach them how to mask ventilate... then they may get a chance to intubate if they have the right attitude.

I don't like it but if it's my wife and/or child on the side of the road needing rescuing, I do want the person there having had at least minimal hands-on experience.

 

[medicine2wallstreet]

EMS students don't get to just appear in my rooms as we induce and get a tube. They get told that they are welcome to watch my rooms and make sure they are able to introduce themselves to the patient beforehand.

Then I teach them how to mask ventilate... then they may get a chance to intubate if they have the right attitude.

I don't like it but if it's my wife and/or child on the side of the road needing rescuing, I do want the person there having had at least minimal hands-on experience.

Boy you sound like an absolute delight. I'm glad you aren't an attending in my department. Act like you're Virginia Apgar. Intubating isn't a pericardiocentesis level skill. Relax man.

 

[kidthor]

Boy you sound like an absolute delight. I'm glad you aren't an attending in my department. Act like you're Virginia Apgar. Intubating isn't a pericardiocentesis level skill. Relax man.

Doing a pericardiocentesis is easier than intubating actually.

 

[abolt18]

EMS students don't get to just appear in my rooms as we induce and get a tube. They get told that they are welcome to watch my rooms and make sure they are able to introduce themselves to the patient beforehand.

Then I teach them how to mask ventilate... then they may get a chance to intubate if they have the right attitude.

I don't like it but if it's my wife and/or child on the side of the road needing rescuing, I do want the person there having had at least minimal hands-on experience.

I have had a similar approach. Anyone who didn't take the time to meet the patient and introduce themselves to me in advance, isn't laying hands on my patient.

Med students, residents, or whatever, who pop through the door as I'm pushing propofol and expect to be performing some sort of procedure are ill-informed. I, too, focus much more on mask ventilation as an essential skill to learn.

 

[imanurse]

tell them that they need to know how to be able to bag mask or put it in an LMA as getting a tube is not going to save anyone if they will struggle in the field

In PA, they can put in a king or combitube (or iGel) but no LMA. ETT is OK for medics but LMA not allowed

 

[2Fast2Des]

Maybe teach them the importance of mask ventilation and the use of basic adjuncts?

They show up to "get some tubes" because that's what they were told to do by their instructors, and they need some boxes checked to graduate. Not their fault that they don't know what's important. Seize the moment, break the cycle, teach them.

We are a fast paced private practice system in the hospital, so as much as I would love to teach, I cannot slow the room down for this either..

Best part, they watch me do everything and then ask me to sign off on their checklist to get their numbers. So they WILL go in the field having only observed yet "met" their minimum, and probably never intubated anything but a manikin.

 

[gunnershow]

We are a fast paced private practice system in the hospital, so as much as I would love to teach, I cannot slow the room down for this either..

Best part, they watch me do everything and then ask me to sign off on their checklist to get their numbers. So they WILL go in the field having only observed yet "met" their minimum, and probably never intubated anything but a manikin.

Why even invite them there then?

 

[2Fast2Des]

Why even invite them there then?

I think they realized that and now longer come here since we did not let them do anything. Not sure who invited them to begin with but probably the ED? asked our department and my chairman went along with it, failed quickly lol

Rumor has it the venerable CCF got rid of its anesthesiologist led rapid response team and replaced with NP\Paramedic staff, so, no I don't want to train any future replacements of us. Wondering if anyone can confirm if this is still true?

 

[pgg]

We are a fast paced private practice system in the hospital, so as much as I would love to teach, I cannot slow the room down for this either..

C'mon

We are too, but letting a student mask a patient for 60 seconds when I was going to mask the patient for 60 seconds anyway doesn't slow the room down.

At worst a failed DL adds 30 seconds to the task.

Best part, they watch me do everything and then ask me to sign off on their checklist to get their numbers. So they WILL go in the field having only observed yet "met" their minimum, and probably never intubated anything but a manikin.

I understand that not everyone wants to teach. I spent 8 years at an academic hospital and when I left one of my job criteria was no residency program, just because I was a little burnt out on teaching and all the outside-the-OR tasks. But a couple minutes of airway instruction in the OR? It's a trivial effort.

 

[Arch Guillotti]

We are a fast paced private practice system in the hospital, so as much as I would love to teach, I cannot slow the room down for this either..

Best part, they watch me do everything and then ask me to sign off on their checklist to get their numbers. So they WILL go in the field having only observed yet "met" their minimum, and probably never intubated anything but a manikin.

Weak

 

[DocVapor]

Boy you sound like an absolute delight. I'm glad you aren't an attending in my department. Act like you're Virginia Apgar. Intubating isn't a pericardiocentesis level skill. Relax man.

Why are you still here?

 

[Anesthesia_Guy]

Boy you sound like an absolute delight. I'm glad you aren't an attending in my department. Act like you're Virginia Apgar. Intubating isn't a pericardiocentesis level skill. Relax man.

Folks we have identified the hard-on.

 

[medicine2wallstreet]

Why are you still here?

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

Intubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

 

[norski]

At my place they had the paramedic students come through to "get some tubes," I didn't let the 1 or 2 try to sneak in when I was at the hospital, and I have a strong feeling none of my other colleagues bothered to let them do anything either, because we never saw them again after a couple weeks of them hanging around trying to tube and dash. One of my colleagues had one of the medic students knock out teeth and bruise up a lip on different patients. The only thing I did was just to tell them that they need to know how to be able to bag mask or put it in an LMA as getting a tube is not going to save anyone if they will struggle in the field. As much as I know they need to learn, not letting it happen on my license and slowing me way down when they just show up out of nowhere and expect it to be given to them. Also flashback to when I was an EMT in college, paramedics were total dickwads to us, so this lead me develop a strong dislike to them

We do this with EMT/med students/interns:

They'll follow one of us from 8am-4pm. That means every single boring esoteric thing and discussion that we take part in.

If a room has five cases, they'll be allowed first chops at BMV, LMAs and iGels for either of these, if they don't show us that they're complete idiots with the BMV. If they do somehow manage one-person-BMV (not EMT style), they might be allowed to try DLing where applicable. If that works out we either tell them to switch to nursing so they can do nurse anesthetist school or apply to a residency in anesthesiology, respective of where they're at.

Maybe teach them the importance of mask ventilation and the use of basic adjuncts?

They show up to "get some tubes" because that's what they were told to do by their instructors, and they need some boxes checked to graduate. Not their fault that they don't know what's important. Seize the moment, break the cycle, teach them.

Yup, that's the case for 99% of med students and interns here.

The problem is that bag/mask ventilation is a harder skill to attain mild proficiency than intubation. It will require a higher n.

Very true, but attaining a passable skillset at inserting an LMA/iGel would not require anywhere near the n of either, so why not just teach them that?

EMS students don't get to just appear in my rooms as we induce and get a tube. They get told that they are welcome to watch my rooms and make sure they are able to introduce themselves to the patient beforehand.

Then I teach them how to mask ventilate... then they may get a chance to intubate if they have the right attitude.

I don't like it but if it's my wife and/or child on the side of the road needing rescuing, I do want the person there having had at least minimal hands-on experience.

Thinking about the Rhode Island EMT-i success rate, I'd much rather have my wife or three kids have an igel or LMA placed in the field by someone on the safe side of Dunner Kruging than have a 50% chance of a clean airway kill.

I have had a similar approach. Anyone who didn't take the time to meet the patient and introduce themselves to me in advance, isn't laying hands on my patient.

Med students, residents, or whatever, who pop through the door as I'm pushing propofol and expect to be performing some sort of procedure are ill-informed. I, too, focus much more on mask ventilation as an essential skill to learn.

Chapeau! Two minutes while the roc is doing it's magic is long enough to create at least some humility.

In PA, they can put in a king or combitube (or iGel) but no LMA. ETT is OK for medics but LMA not allowed

That is just nonsensical. ETT/iGel/King good, but no lmas?

 

[nimbus]

We do this with EMT/med students/interns:

They'll follow one of us from 8am-4pm. That means every single boring esoteric thing and discussion that we take part in.

If a room has five cases, they'll be allowed first chops at BMV, LMAs and iGels for either of these, if they don't show us that they're complete idiots with the BMV. If they do somehow manage one-person-BMV (not EMT style), they might be allowed to try DLing where applicable. If that works out we either tell them to switch to nursing so they can do nurse anesthetist school or apply to a residency in anesthesiology, respective of where they're at.



Yup, that's the case for 99% of med students and interns here.



Very true, but attaining a passable skillset at inserting an LMA/iGel would not require anywhere near the n of either, so why not just teach them that?



Thinking about the Rhode Island EMT-i success rate, I'd much rather have my wife or three kids have an igel or LMA placed in the field by someone on the safe side of Dunner Kruging than have a 50% chance of a clean airway kill.



Chapeau! Two minutes while the roc is doing it's magic is long enough to create at least some humility.



That is just nonsensical. ETT/iGel/King good, but no lmas?

There is some evidence that paramedics doing basic airway management +- SGAs leads to better outcomes than intubation or attempted intubation.

http://www.jrcalc.org.uk/wp-content/uploads/2013/11/airway17.6.8.pdf

https://ccforum.biomedcentral.com/counter/pdf/10.1186/s13054-015-0808-x.pdf?pdf=button%20sticky

 

[nimbus]

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

Intubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

The problem is that paramedics get minimal experience in training and continue to have minimal experience in practice. It’s easy to develop and maintain competence if you do it every day but that is not the reality for most paramedics. The handful of OR intubations they do is just a show. It does not develop competence, let alone expertise.

 

[pgg]

The problem is that paramedics get minimal experience in training and continue to have minimal experience in practice. It’s easy to develop and maintain competence if you do it every day but that is not the reality for most paramedics. The handful of OR intubations they do is just a show. It does not develop competence, let alone expertise.

Agreed, which is why it's important for us to give them reps with mask ventilation, adjuncts, LMAs, and then get their intubation-homework-papers checked off.

When it comes to mask ventilation, they start off worse than useless, generally mashing the mask down onto the face and worsening airway obstruction. A few reps with proper technique and they are all much improved. Even with few reps in the field as professionals, those basics probably stick with them. It's so easy for us to do. We should do it.

 

[DocVapor]

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

Intubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

Having been a medic before medical school, and thus having been on both ends of this situation, I know wtf I'm doing with them so why don't you take your self righteous bravado elsewhere. If you want to let them knock your patients teeth out and whistle on their way out of the OR while you call for the fiberoptic to go fishing, be my guest. Your other points have been refuted already so I won't waste any further time on you.

 

[medicine2wallstreet]

They ain't knocking teeth out. Hell I never knocked a tooth out and I was an absolute clown as a med student. I'll whistle all I want!

 

[Angus Avagadro]

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

In

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

Intubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

tubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

I believe your comments are a bit misguided. You can Google that to see what I mean. When you are an attending, and your malpractice is on the line feel free to teach as much as you want, take all the time you want, as the rest of the OR glares at you. You have to be able to UN do anything your trainee does, because it's all on you. Intubations are easy,..... until they aren't. We trained the paramedics from our Urban Ems. They spent the day assigned to an attending. Basic airway management was stressed and basic laryngoscopy was taught when an appropriate patient presented. From your comments, I suspect you don't take instruction or accept criticism well. Any CA 2,3,or 4 who thinks intubations are easy, with N's in the 100's, well just doesn't know what they don't know yet. Our specialty teaches all of us some humility.

 

[Arch Guillotti]

If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked.

lol in the real world we ask the patient if it's ok first.

 

[Dr. Rude]

lol in the real world we ask the patient if it's ok first.

Not true everywhere. Rarely ever gets mentioned. Blanket rarely read consent form talks about having "trainees/learners" participate in care

 

[dabears505]

I let the paramedic students try every single time. It's actually much more important for them than a med student or intern who has zero chance of ever intubating anyone ever again outside of that month. Luckily we have McGrath mac 3 blades with video that let me see what the student is doing. I make sure they are not applying excess force and damaging teeth. How else are they supposed to learn? Regardless of what the literature says about field intubations, sometimes they just have to be done. Please, you can slow your room down 2 minutes to let them try. They don't need to show any interest in Anesthesia or follow you around the whole day to get a chance. I give a quick talk about possible induction agent choices and paralytics.

 

[medicine2wallstreet]

Thank you da bears for being a reasonable anesthesiologist. Thank god. I was begging to lose faith in my colleagues on here.

 

[medicine2wallstreet]

lol in the real world we ask the patient if it's ok first.

You're wrong. It's in the consent in teaching hospitals. Hell it's not even an anesthesia consent thing. It's in the admission forms every patient signs. As a patient if you don't want trainees practicing then go to a different hospital. They sign the consent.

 

[Arch Guillotti]

You're wrong. It's in the consent in teaching hospitals. Hell it's not even an anesthesia consent thing. It's in the admission forms every patient signs. As a patient if you don't want trainees practicing then go to a different hospital. They sign the consent.

Actually it is in the consent and no I don’t work in a “teaching” hospital.

 

[kidthor]

You're wrong. It's in the consent in teaching hospitals. Hell it's not even an anesthesia consent thing. It's in the admission forms every patient signs. As a patient if you don't want trainees practicing then go to a different hospital. They sign the consent.

A patient can revoke consent at any time, including refusing to have trainees intubate them.

 

[2Fast2Des]

C'mon

We are too, but letting a student mask a patient for 60 seconds when I was going to mask the patient for 60 seconds anyway doesn't slow the room down.

At worst a failed DL adds 30 seconds to the task.



I understand that not everyone wants to teach. I spent 8 years at an academic hospital and when I left one of my job criteria was no residency program, just because I was a little burnt out on teaching and all the outside-the-OR tasks. But a couple minutes of airway instruction in the OR? It's a trivial effort.

Yeah I chose PP specifically not to teach, but if an approach is made pre-op and respectfully asked it's one thing. Can't just pop up in the middle of induction and take a claim without even introducing one's name. Kids these days, no manners...

 

[GassYous]

How easily accessible are you preop? I just show up and set up as they move the patient to the or table. I'm not usually sitting around in the or fiddling with myself while I wait for trainees to come by to introduce themselves to me and the patient. I don't tell patient about the tech that is assisting me or introduce the rep that is providing the hardware that is going into their body.

I do like for people to know my name and introduce themselves properly but I remember what it is like to be a trainee trying to get involved in procedures. You don't know where anything is, the people in charge don't explain anything to you and you have no idea about the culture of the or. I remember all the douchebags very clearly as well as the great teachers that I've had throughout the years.

 

[2Fast2Des]

How easily accessible are you preop? I just show up and set up as they move the patient to the or table. I'm not usually sitting around in the or fiddling with myself while I wait for trainees to come by to introduce themselves to me and the patient. I don't tell patient about the tech that is assisting me or introduce the rep that is providing the hardware that is going into their body.

I do like for people to know my name and introduce themselves properly but I remember what it is like to be a trainee trying to get involved in procedures. You don't know where anything is, the people in charge don't explain anything to you and you have no idea about the culture of the or. I remember all the douchebags very clearly as well as the great teachers that I've had throughout the years.

We have to bring the pt to the OR but otherwise hanging around in pre-op or the lounge otherwise so there are opportunities for them to catch us before hand.

I get your second point.. It's hard to be a good teacher when you are in an environment where it's hustle time.. but true sometimes can forgot where we come from when not in the academic environment

 

[Gasworks]

I let the paramedic students try every single time. It's actually much more important for them than a med student or intern who has zero chance of ever intubating anyone ever again outside of that month. Luckily we have McGrath mac 3 blades with video that let me see what the student is doing. I make sure they are not applying excess force and damaging teeth. How else are they supposed to learn? Regardless of what the literature says about field intubations, sometimes they just have to be done. Please, you can slow your room down 2 minutes to let them try. They don't need to show any interest in Anesthesia or follow you around the whole day to get a chance. I give a quick talk about possible induction agent choices and paralytics.

Same goes for RTs.. every airway they get is an emergent intubation on the floor that I won’t be called for.

 

[Anesthesia_Guy]

You're wrong. It's in the consent in teaching hospitals. Hell it's not even an anesthesia consent thing. It's in the admission forms every patient signs. As a patient if you don't want trainees practicing then go to a different hospital. They sign the consent.

What a complete clown.

 

[PpfSuxTube]

Because I will not be a soft anesthesiologist. If a EMS student rolls in and wants to intubate I'll absolutely let them in the future. No questions asked. I am for educational gain. I want the EMS person to have excellent clinical chops because they're saving a person in extremis. You're intubating a ASA1 lap chole in optimal conditions and acting like it's all that difficult. I want these kids to be very good at what they do. You want the person saving your family members life on the side of the road to have minimal experience? What the hell is wrong with you.

Intubation isn't even that difficult. You aren't Michael Debakey. Don't act like you are.

You don't understand what you're talking about on so many levels.

Have you taught anyone anything?
When you are 9 or 10 years in the game with daily EMS buddy rolling in late to get some tubes, come back to us.
Why are you name dropping random physicians?

You can teach "excellent clinical chops"? I doubt that very much

 

[okayplayer]

Thank you da bears for being a reasonable anesthesiologist. Thank god. I was begging to lose faith in my colleagues on here.

You’re not our colleague.

 

[Bryan O’Blivion]

You're wrong. It's in the consent in teaching hospitals. Hell it's not even an anesthesia consent thing. It's in the admission forms every patient signs. As a patient if you don't want trainees practicing then go to a different hospital. They sign the consent.

I advise you to read about medical battery.