I took a patient into the A&E department of one of our major hospitals a couple of nights back.
The details of the patient aren’t important for this one, just the fact that he had a GCS of 5, was tolerating both an OPA and an NPA.
I was getting excellent air entry via BVM and his SaO2 was in the high 90`s throughout my time with him, once I had control of the airway.
We cannot RSI, and I decided not to try and intubate due to the short transfer time, the risk of laryngospasm and the fact that I was managing just fine with BVM thank you!
I got to the hospital and handed over the patient to the waiting team, they set to work and the A&E registrar tried to intubate her, but found that her larynx was indeed spasming as soon as the tube got anywhere near. Anaesthetics arrived a couple of minutes later and the consultant, a lady whom I used to work with when I was a theatre (OR) nurse, strode into the resus and proclaimed in a loud and proud voice…
“Right! The first thing I need is a good quality firm pillow! I cannot intubate this patient without a good firm pillow”
I looked up from my patient report form, mouth agape, looked at Sam, one of the A&E nurses and just smiled and shook my head.
As I said in the title chaps – two different worlds!!