Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 30 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Awake intubation provides the opportunity to preserve spontaneous respiration and prolong the time for intubation attempts. Upright fiber-optic–assisted intubation through a Williams or Ovassapian airway is a common and effective approach.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 29 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
During a cricothyroidotomy, passing a bougie through the neck incision to serve as an ETT guide has been reported successful. Major complications include esophageal perforation, subcutaneous emphysema and bleeding.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 28 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Surgical cricothyroidotomy is reserved for the emergency airway situation when an extraglottic airway cannot be effectively employed because of upper airway abnormalities, blood or secretions that obviate proper placement and function.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 27 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Intubation through supraglottic device (SGDs) has proven successful after failed direct laryngoscopy. A number of SGDs provide one-step intubation through the device (Ambu Aura-i, Air-Q/ILA, LMA Fastrach and Classic Excel, i-Gel).

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 26 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Intubating supraglottic devices (SGDs) are appropriate primary or rescue strategy devices. SGDs can be placed into the upper airway to reestablish adequate oxygenation and ventilation without significant technical expertise in many cases.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 25 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Most algorithms recommended a stepwise approach to difficult airway management, using tracheal intubation, face mask ventilation and supraglottic airway devices, followed by surgical airway if life-threatening situation exists.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 24 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
In the setting of a predicted difficult airway management, indirect optical devices and videolaryngoscopy provide better glottic visualization and maximize the likelihood of intubation success.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 23 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
A difficult airway is defined as the presence of clinical factors that complicate ventilation or intubation. The incidence of difficult airways encountered during emergent intubations is reported to be 10%.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 22 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Direct laryngoscopy failure is frequently associated with the inability to visualize the glottis, whereas failure in videolaryngoscopy is often related to the inability to pass the ETT. Each device has unique technical considerations.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 21 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Indirect laryngoscopy incorporates angulated blades (i.e., GlideScope, McGrath, C-MAC), whereas others incorporate a channel (i.e., Airtraq, Pentax) to facilitate ETT placement through a more anterior glottis with a neutral positioned head.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 20 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Indirect laryngoscopy devices provide video or optical imaging using mirrors and prisms to improve glottic visualization in individuals in whom alignment of the airway axes is difficult.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 19 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
The broader surface of the Macintosh blade may provide better upward displacement of upper airway soft tissue, and the longer and narrower profile of the Miller blade may assist in the setting of narrow mouth opening or a long epiglottis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 18 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
The Miller blade is long and straight, with a slightly curved tip. It is generally inserted using a midline approach, and the distal end is used to directly lift the tip of the epiglottis. Blade sizes 3 or 4 are appropriate for most adult procedures.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 17 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Macintosh and Miller blades are designed for endotracheal tube placement. The Macintosh blade is broad, curved and includes a flange to displace the tongue to the left when the blade is introduced into the mouth from the right side.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 16 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
The combination of an induction agent with a paralytic produces optimal intubating conditions. Historically, Succinylcholine has been one of the most commonly used depolarizing muscle relaxants because of its rapid onset and short duration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 15 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
In intubation, caution should be taken in the catecholamine-depleted patient, as Ketamine can act as a negative inotrope. Although Ketamine can relieve bronchospasm, it may also increase secretions and promote laryngospasm.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 14 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
In rapid-sequence intubation, Ketamine increases heart rate, blood pressure and cardiac output and has been shown to provide similar intubating conditions and outcomes as Etomidate in large, prospective randomized trials.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 13 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
In rapid-sequence intubation, the initial induction agent doses should be reduced by 25%–50% in the elderly and in patients with hypotension, hypovolemia or significantly impaired cardiac function.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 12 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Rapid-sequence intubation (RSI) is the standard of care in most emergency airway management settings because of its high rate of success. The goal of RSI is to optimize conditions for intubation before desaturation and to prevent aspiration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 11 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
A soiled airway increases the risk for aspiration complications and decreases first-pass success. Emesis, hematemesis and hemoptysis are more often encountered during emergency airway management.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 10 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
During intubation, vasopressors should be used for periprocedural hypotension. Although a fluid bolus before induction has been shown to reduce the incidence of associated cardiovascular collapse, this practice remains controversial.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 09 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Critically ill patients are at risk for periprocedural hypotension, which can lead to cardiac arrest. Hypotension during intubation is common, often the result of decreased catecholamines, the physiologic effects of many induction medications.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 08 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
If the BMV using an oropharyngeal airway technique fails to improve hypoxemia, a second-generation supraglottic airway should be used. The devices are designed to provide a better seal of the airway and are safer since they allow gastric aspiration.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 07 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Avoiding hypoxemia is essential to preserve safe conditions during intubation. If oxygen saturation drops, the first rescue maneuver is the BMV technique using an oropharyngeal airway and meticulous attention to patient positioning.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 06 Jul 2026 12:00:00 +0000

Category: Critical Care Nursing
Rapid-sequence intubation has an inherent delay of 45-90 seconds between medication administration and laryngoscopy. In patients with refractory hypoxemia, there is no safe apnea time and awake intubation should be strongly considered.