non-therapeutic hyperventilation

I had the intubation class today. It was a pretty exclusive group -- only one nurse bothered to show up. That's okay. She got to be the test subject for the program. And she did very well. We were discussing rescheduling for the rest of the nurses, and my idea is just to do the program with them one or two at a time on Tuesday nights, when I'm on call anyway. My hope is that keeping the classes super small will reduce the problem of any nursey groupthink about not being able to intubate or manage an airway alone. I doubt it's a coincidence that the one nurse who did make time to show up for the class is a former EMT who, after 13 years inside, is sick of it and wants to become a paramedic. We discussed the relative merits of several education programs. She is the rare bird who already has her RN license, and is motivated enough -- and has enough respect for the separate knowledge base of EMS -- to go slog through a two year medic program. I'll be thrilled if she does go through with it. We need her, and about a hundred more like her in this state.


Dr Y. was also there, with a decent PowerPoint presentation on RSI (that's rapid sequence INDUCTION, people, not INTUBATION. . . although the error has become common enough to be the accepted truth). He was medical control back when I was just a little bitty paramedic in JC. What a relief to not have some random ER doc as medical control. It would really slow things down if I had to take the time to sell someone on the purpose, training and scope of practice for paramedics before we could get anything done.

He liked the troubleshooting list I'd prepared for intubation in the SCTU environment, and said he'd be taking it back to his ER for use there, as many of the potential complications overlap. That felt pretty good.

My preceptor also seemed really happy with the class, although he was rolling his eyes a bit at the poor turnout and the regrets emailed in at 10 pm last night from a few of the other nurses. We had all of the material we needed for a successful class, although the brand-new intubation mannequin head is so stiff that we could barely displace the jaw enough to see the cords. (Rich, our EMT who can just about bench the bus, was our most successful laryngoscopist.)

So now, all that's left is to write it up and do the online discussion with the other PSPR students. I was able to score some more journal articles at the hospital library this afternoon. The librarian was very helpful in accessing some articles that I was unable to get online -- once she determined I deserved her help.

I'm certain that a good deal of the anxiety I've experienced in preparing this project has been at the threat of success, not failure. The thought of failure in this program is dismal, and unappetizing, and I have no plans to fail. Some days, though, my plans for success scare the hell out of me.