Intubation Experiance

I get about two per month as well. Plus I have access to the OR anytime I need it. It seems as if some of our medics get several tubes every shift, some people just luck into it.
 
I average about <12 a year. Some people get more, depends on luck I guess.

325.
 
10 or less a year
 
Thanks. I find it quite fascinating, and it does throw into perspective some of the opposition to Paramedic intubation that exists. I usually get 2-5 tubes a week, and I think that I really don't get enough to maintain competence.
 
Smash I don't want to derail your thread but after reading this I'm wondering how many medics are provided the opportunity to score OR time to maintain and practice this skill in a controlled environment under direct physician/advanced provider supervision? I can start another thread if you would like me to rather than changing the direction of yours.
 
NVRob said:
Smash I don't want to derail your thread but after reading this I'm wondering how many medics are provided the opportunity to score OR time to maintain and practice this skill in a controlled environment under direct physician/advanced provider supervision? I can start another thread if you would like me to rather than changing the direction of yours.
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I wish I could have had some chances in the OR but its really luck of the draw there. Depends on how nice the hospital staff is feeling that day. All of my tubes have come from internship hours but that is pure luck on my part. I've been very lucky to get so many chances, my preceptors have been great for the most part.

We do not get placed in the OR for intubations by our program.
 
Smash said:
Thanks. I find it quite fascinating, and it does throw into perspective some of the opposition to Paramedic intubation that exists. I usually get 2-5 tubes a week, and I think that I really don't get enough to maintain competence.
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Smash, I'm not exactly sure what you do, are you a CRNA? I'm just curious :P

I know that with my paramedic program, we needed at least 4 shifts and 10 intubations in the OR, if there were spots open we were allowed to schedule more as well. Now, that is a very, very tiny amount, but I suppose it's a lot better than getting no OR time like some programs.

I haven't actually heard if we're allowed some OR time with my current company, but most ER docs will let us have a shot at intubating if we happen to be around when they're about to do it. That being said, I will ask around today and see if we actually get any OR time.
 
I'm just a medic in a large service. 2-5 is an average. Last week I got none at all. The week before I got 6, so it comes and goes obviously. I'm not intending to denigrate anyone's abilities, but I've always been confused as to why there was a distinct anti-ETT sentiment from some quarters and this certainly sheds some light on that.
 
The lack of opportunity for students to practice intubation in the field isn't because of any anti ETT sentiment. Unfortunately its because none of the counties or hospitals feel comfortable allowing it. Can't say that I blame them though. For every 1 student who seems competent with the skill, there are 3 who would surely make matters worse.

If you look like you know what you are doing, preceptors may give you a shot in the field. But most medic students will never get a chance outside of the classroom.
 
Chief Complaint said:
If you look like you know what you are doing, preceptors may give you a shot in the field. But most medic students will never get a chance outside of the classroom.
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Then they shouldn't be graduating from medic school. If you can't demonstrate competence in the classroom and the field in a skill they shouldn't be graduating, personally.

The Preceptors job is to be a teacher, they should be helping the student develop the competence.
 
NVRob said:
Then they shouldn't be graduating from medic school. If you can't demonstrate competence in the classroom and the field in a skill they shouldn't be graduating, personally.

The Preceptors job is to be a teacher, they should be helping the student develop the competence.
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Couldn't agree more, things are just wacky here. You should see some of the clowns that passed registry with me. Like you said, many of these folks shouldn't even have been able to test. It's quite frustrating.

These students are the ones that ruin it for the rest of us when it comes to field intubations. If the hospitals and counties saw that only competent students were allowed to attend clinicals/internships, they would probably be more likely to work with us.

I agree that its a preceptors job to teach, and most of them do a great job, but I can't blame then for not wanting students to tube patients on their watch when some of them clearly have no clue what they are doing.
 
Very true. I'm very blessed with my school and how our internship is set up. We have the same preceptor for the entire internship unless you are extended, then your preceptor changes at the extension. It allows you to gain your trust of the preceptor. Interns here run the entire show for the most part while the preceptor just hangs out with the FD Officer and watches or helps if we delegate something to them. They will step in if your struggling or things are going south. I am not to my internship phase yet, we do didactic then clinical then internship, I have 2 months let of didactic.

From what I have heard from talking to other medic students on here is that they have multiple preceptors.
 
NVRob said:
Very true. I'm very blessed with my school and how our internship is set up. We have the same preceptor for the entire internship unless you are extended, then your preceptor changes at the extension. It allows you to gain your trust of the preceptor. Interns here run the entire show for the most part while the preceptor just hangs out with the FD Officer and watches or helps if we delegate something to them. They will step in if your struggling or things are going south. I am not to my internship phase yet, we do didactic then clinical then internship, I have 2 months let of didactic.

From what I have heard from talking to other medic students on here is that they have multiple preceptors.
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You're a lucky sonovabitch, I haven't had the same preceptor twice. Some are happy to let you run the show, others would prefer if you just do the simple tasks....which does very little to help the student.

Medic students here (I and P) do internships with 2 rather large counties so scheduling can be a nightmare. It's very common to have a different preceptor every time.
 
Chief Complaint said:
You're a lucky sonovabitch, I haven't had the same preceptor twice. Some are happy to let you run the show, others would prefer if you just do the simple tasks....which does very little to help the student.

Medic students here (I and P) do internships with 2 rather large counties so scheduling can be a nightmare. It's very common to have a different preceptor every time.
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Thats nuts. I don't get how that is an effective education model :wacko:

I'm definitely spoiled. I work for the agency as a per diem Intermediate that also runs my school and is where we do our internship, so most of the preceptors already know me and let me do more ALS assessments before they will start doing their thing when I'm working. They'll let me interp 12 leads then check it to make sure its correct and bounce ideas for treatment and differentials off me when they are stuck. :P
 
NVRob said:
Then they shouldn't be graduating from medic school.
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I got 0 tubes in clinicals and 0 in my field internship. I was a Paramedic for a year before my first field intubation, and it also happened to be my first RSI. Passed it, and the subsequent tubes, all on first try. Should I not have graduated? Some people just aren't there when the tubes are, always the wrong place at the right time. I can't tell you how many tubes there were at locations I was doing clinicals, but I was off doing some menial tasks for a nurse that could have waited.

Infact, I went though all of EMT school, all of Paramedic school, clinicals, and up until my final 2 shifts of Paramedic internship before I had my first cardiac arrest... and I was in urban Ft Worth and Dallas for these. (And with my luck, the patient was not an ETI candidate due to neck cancer)



What about crics (surgical / needle)? Chance of you getting one during your internships is minimal, which is why they spend so much time teaching on mannequins and pig trachs.

Same with pacing. Or synchronized cardioversion. My first pacing of a patient was this past July. Hell, I've never shocked a cardiac arrest, as all of mine (and I've had my fair share in recent months) have all been asystole. Should I not be trusted with defibrillation, either?



Or any of the other high acuity / low frequency Paramedics do. Just because you don't do one on a real live patient doesn't mean you're incompetent in it, just inexperienced. Inexperience doesn't mean failure. Some people get multiple births in one year, some never get on in their whole career. Right place at right time is all it equates to.
 
NVRob said:
Then they shouldn't be graduating from medic school. If you can't demonstrate competence in the classroom and the field in a skill they shouldn't be graduating, personally.
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I definitely specified competence. It should have said "the classroom or the field" instead of and. Sorry english was never my strong suit I should have worded it better.

If a preceptor isn't allowing an intern to perform skills because they are comfortable with the way the student is acting, talking or for whatever other reason there's an issue there that needs to be addressed prior to graduation...
 
Our preceptors have no affiliation with the school so they have no say as to whether a student graduates. What they should be doing is reporting to the school when a student shows up who clearly needs some more training/education, and suggesting that they try again once they have grasped the basics.

Linuss' post makes sense to me. There are quite a few bright medics in my program that unfortunately will get zero intubation attempts before they get out in the field. They will be fine when their time comes to drop a tube. It's the douche who still can't figure out how to start an IV (but somehow passed that station at registry) who is going to smash all of the patients teeth out when they go in for their first attempt.
 
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