Tenesma said:
when they run the SICU - then it is another story???? what is that supposed to mean? Are you implying that ENTs are all of a sudden "board certified" in surgical critical care?
Oh, you can manage all the acids, bases, electrolytes, rhythm things, and vent parameters all you want.
We defer on all that stuff, but when you're working in a "closed" unit and they're managing surgical issues, it can be a little frustrating.
Above all, critical care is your ball game. There are just certain things that intensivists do that we don't agree with. But, that's how it goes, I guess.
Tenesma said:
and by the way, just cause an ENT feels that it is safe to extubate - if the airway is lost and there is a bad outcome, who goes to court?
Oh, come on. You can't suggest that it's that simple. You don't think an attorney with half of a brain won't pull us in as well?
Anesthesiologists do more intubating than we do, and they have a lot of tools and tricks of the trade for accomplishing it. We have our devices as well, and they're not surgical. And not to toot my own horn, but we're pretty good at it as well.
I think that when we have a good relationship with anesthesiologists, they're more willing to let us back them up and vice versa. It goes both ways. I've had anesthesia attendings intubate for me when I've been unable to intubate on the floor or in the OR, and I've endoscopically intubated or used the Dedo to intubate when they've been unable.
