Endotracheal intubation & AHA ACLS instructor

[Gastrin]

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Are ACLS Instructors expected to know AND teach endotracheal intubation?

I completed my AHA ACLS (provider &) instructor course, but we weren't taught endotracheal intubation.

Can some please tell me if this is the norm in USA?
Or do all ACLS instructors need to know and be able to teach endotracheal intubation?

Thanks.

 

[quique2]

Not sure if the IM forum is the best place to ask. Anyway, as an ACLS instructor you *should* be able to teach basic endotracheal intubation and airway management... however, the advanced airway station is completely optional because advanced airways are not truly taught as part of the course, nor are they tested. It's in your instructor manual...

Many courses do include a short practical session just so the students can be exposed to not only endotracheal intubation but laryngeal masks, oropharyngeal cannulas, etc. It depends on the instructors, training center and what audience you're catering for.

 

[dragonfly99]

Agree with the above.
The emphasis in ACLS is on restoring circulation and getting the patient to an appropriate higher level of care. Most of the time that involves potentially just bagging the patient, etc., but may involve more airway management. A lot of times if you are in a major metro area, the definitive airway placement can be done in the ER and/or ICU and by someone like an anesthesiologist, ER doc or respiratory therapist or someone else with a lot of airway management/intubation experience. There are a lot of ppl who take ACLS and are required to have it, but not everyone needs to be an airway management expert.

 

[joeDO2]

True it isn't required that ETI be taught but IMO the instructor should have some experience with it. You will likely be teaching some students who will be familiar with intubation and you should be able to at least speak intelligently about its use and how it is incorporated into the resuscitation. In addition, there are testable items in the curriculum dealing with tube confirmation etc that need to be addressed. In order to fully understand those items you should at least have a basic grasp of the procedure. I would also say that if you are not going to teach ETI, that you teach another advanced airway, ie LMA, king, etc. Mask ventilating a patient can sometimes be much more difficult than one would anticipate. Its important to have another option should you need it during the resuscitation.

 

[jerseytrash]

Agree with the above.
The emphasis in ACLS is on restoring circulation and getting the patient to an appropriate higher level of care. Most of the time that involves potentially just bagging the patient, etc., but may involve more airway management. A lot of times if you are in a major metro area, the definitive airway placement can be done in the ER and/or ICU and by someone like an anesthesiologist, ER doc or respiratory therapist or someone else with a lot of airway management/intubation experience. There are a lot of ppl who take ACLS and are required to have it, but not everyone needs to be an airway management expert.

I absolutely think teaching advanced airway management is important for IM residents. Sure, you're not going to be doing it on a regular basis on the floors (usually it's just bagging + waiting for RRT + intubating by anesthesia or pulm/cc or whoever) but it's def something that at some point i think an IM resident SHOULD know.

There's a lot of skills that were often "restricted" to other specialties (particularly EM) which IM needs to become more familiar with - and that definitely includes advanced airways, IMO. Another one is ultrasound use, being able to do a FAST, bedside echo, evaluating an effusion with ultrasound, ultrasound guided procedures, etc all need to become the mainstay of IM education because that's the future.