Yes, some nurses can intubate patients. With that said, most registered nurses do not perform intubations.
Whether nurses intubate depends on their discipline, facility protocols, the scope of practice, and state regulations.
To intubate, nurses must be thoroughly trained and receive specialized education.
This may include taking ACLS classes, receiving physician oversight, and obtained advanced credentials in related fields.
Furthermore, most nurses who intubate are advanced practice registered nurses with extensive training and advanced degrees.
Therefore, it is unlikely most registered nurses will incubate patients. It’s more likely that nurses play supportive roles during patient incubation.
This includes monitoring patient vitals, administering medication, and addressing issues within their scope of practice.
Nurse Specializations That May Perform Intubations
- Flight nurses (highly skilled FNs with advanced training and experience)
- ICU nurses (depending on state regulations, training, and emergency)
- Neonatal nurse practitioners
- Nurse anesthetists
As previously mentioned, whether nurses perform intubations depends on their training, specialty, and the facility’s guidelines.
Most nurses will not perform intubations. However, APRNs and a few highly trained nurse specialists intubate.
Unfortunately, there aren’t blanket policies for nurses performing intubations countrywide.
As a result, intubation policies are often overseen by the facility the nurse works for.
With that said, most intubations are performed by respiratory therapists, neonatal nurse practitioners, and MDs.
Intubation Training and Procedure
An intubation is a procedure performed when an individual cannot regulate their own breathing and receive adequate oxygen.
Essentially, tubing is placed into the individual’s throat, which opens the windpipe and makes it easier for oxygen to reach the lungs.
Moreover, a ventilator pump is attached to the tubing allowing oxygen to reach the lungs more easily.
It helps the user breathe out harmful carbon dioxide.
Intubations are performed during anesthesia or when utilizing medication that causes temporary paralysis.
It’s also performed when a patient has an injury or illness that prevents them from receiving adequate oxygen supply.
During these times, intubation procedures are essential for ensuring patients remain healthy and stable.
Because the intubation process requires careful application and administration, medical professionals must be properly trained.
Intubation training provides an education that allows highly trained medical professionals to perform intubations with little risk.
Techniques Learned During Intubation Training
- APB instruction
- Proper head placement techniques
- Preoxygenation
- Visual throat assessment
- Laryngoscope insertion and utilization
- ET tube placement and operation
- BBM flow
This is a summary of what’s provided during intubation training.
The actual training process is a lot more in-depth with instructors, machine operation, and anatomical models.
Trainees also learn about specific guidelines such as the DAS (Difficult Airway Society) guidelines for proper airway management.
Nursing Roles During Intubation
A nurse’s roles during intubation various depending on their department and experience.
Nurses work alongside other nurses, respiratory therapists (RTs), medics/technicians, and physicians.
Most nurses focus on direct patient care and monitor vitals throughout the incubation to ensure that patients are stable and healthy.
During this time, nurses assess the patient’s pre intubation vitals and medical histories to obtain a baseline.
This allows them to determine what equipment, fluids, and procedures may be necessary to maintain stabilization.
However, nurses must seek physicians’ approval before administering certain procedures.
Common Tasks and Roles
- Collect patient medical histories and labs
- Observe HR monitors, BP cuffs, arterial lines, and other equipment
- Prepare and administer medications
- Chart and update medical records
As mentioned previously, nurses work with the physician to determine their patient’s needs.
For example, physicians inform the nurse of the specific medications and dosages needed to treat the patient.
As a result, the nurse can properly prepare for their time with the patients.
Nurses chart their actions and patient responses to maintain medical records, monitor changes accurately, and determine their recovery.
While managing patients, nurses often work together as part of a team to ensure that procedures are properly followed.
To be part of intubation, nurses must be timely, manage multiple tasks, understand how to operate various equipment, and have good communication skills.
Can ICU Nurses Intubate?
I have found ICU nurses usually do not perform intubations in most cases.
However, some facilities allow for intubations when a physician provides oversight.
However, it is largely dependent on the healthcare facility and its guidelines.
Furthermore, nurses who perform intubations must be highly trained and have recent experience.
This is because improper training or procedures can cause complications and other issues.
Although the risk of complications occurring is low when performed properly, it’s still a risk. Therefore, most hospitals limit who can perform intubations.
Can Flight Nurses Intubate?
Yes, flight nurses can intubate patients.
This is because flight nurses provide pre-hospital medical care and must understand advanced life support techniques to ensure proper patient care.
Because flight nurses encounter emergencies, they must be highly trained for unexpected situations.
This includes encountering patients that have difficulty breathing and need oxygen support.
Beyond that, flight nurses learn other advanced life support techniques to ensure patient safety in emergencies.
However, specific procedures are dependent upon their institution and situation.
The kinds of patients flight nurses encounter are largely dependent on their line of work and environment.
Therefore, two flight nurses can have very different experiences based on where they operate.
Can More Nurses be Trained to Intubate?
Yes, most registered nurses can be trained to intubate. In fact, many learn intubation techniques at some point, such as during ACLS training.
However, one issue that arises is how often they perform intubations.
In most cases, nurses aren’t required to perform intubations. As a result, they lack the practice required to maintain the adequate experience.
In turn, facilities are less likely to make it common practice for nurses.
Furthermore, hospitals and healthcare facilities have guidelines, rules, and regulations.
Perhaps, who can perform intubations reduces their legal risk.
Therefore, it’s easier to leave intubations to APRNs, respiratory therapists, and physicians.
Why Are Patients Intubated?
Intubations are performed to provide oxygen to individuals with difficulty breathing by opening their airways. This procedure occurs for several reasons.
For example, when a patient is given anesthesia or medication, it prevents them from breathing independently.
It can also be performed due to a blockage, injury, or illness. For instance, when an individual experiences trauma or has a collapsed lung.
Without proper intubation, patients could suffer from various medical complications.
To illustrate, a lack of oxygen can lead to lung failure, heart problems, and mental issues from a lack of oxygen to the brain.