Intubation

All specialties in medicine like to claim their turf and mark their territory. The cardiologists, no doubt are the gurus of the EKG and managing chronic heart disease. The Nephrologists own the kidney, dialysis etc. Surgeons, often think they own everything but they do own the surgical procedures, no questions about that. Emergency doctors have to know all of these things but are not the best at many but do have a few areas they own.

Resuscitation (running codes), airway management and other acute medical emergencies are what EM doctors like to claim as their expertise. Airway management can sometimes be a turf war or a battle with Anesthesia. Anesthesiologists intubate (manage the airway) everyday. Every surgery that requires general anesthesia requires the patient to be intubated and it is the Anesthesiologists who do this day in and day out. This is done under a nice peaceful controlled environment with lots of time and the patients are stable and usually the intubation is nothing more than routine.

In the emergency department the Emergency doctors do intubations as well, but these are Rapid Sequence Intubations (RSI). It is a different game all together. These are critically ill patients who are often crashing and the airway must be managed and protected very quickly in a high pressure atmosphere. This type of intubation or airway management is what Emergency Physicians like to claim as their turf. There usually is not much argument or turf battles when it comes to Rapid Sequence Intubations. Funny, no other specialty is trying to steal or take this procedure from the EM docs.

Anyways this is a brief  introduction to intubations or airway management as I am currently on an anesthesiology rotation right now and doing several intubations / day. The boring peaceful, relaxed kind that Anesthesiologists are no doubt the masters. I am learning a lot and there is no better way to fine tune my intubation skills than to intubate lots of patients. I have had to do a good number of Rapid Sequence Intubations while on EM rotations but not enough to fell super comfortable, so this rotations is the perfect tool to get my technique and motor skills where they need to be for intubating.