I think ER is very realistic in it portrayal of medical procedures however there's one thing that bugs me. I was watching the old episode "Exodus"(one of my favourites) and noticed a number of very alert conscious people with breathing tubes stuck down their throats. Is this possible.... i mean it has to be extremely uncomfortable.....what about the "gag" reflex!. Sure if they were very sedated etc maybe they could tolerate it......but these people are AWAKE!!! what about the little girl (remember in the elevator)she was awear of everything and responded to questions by sign language. Just wondering what people thought.

-- Emma (empatto@hotmail.com), February 20, 2000

Answers

Many clinical situations warrant intubation in the awake state. It is only used when deemed necessary by the anesthesia provider. It is certainly not as common as an induced intubation, but it is most definitely an accepted method of anesthesia.

-- bratan (bjones40@bellsouth.net), February 20, 2000.

in reference to the gag reflex, i think they have an anesthetic spray that they spray in the throat, to numb it. like when they scope your stomach , etc.

-- Alexis (lexicat1@webtv.net), February 21, 2000.

I can see what your saying..but i still don't think its possible. A persons airway is very sensitive compared to that same individual's food pipe....people have tubes stuck down their oesophagus all the time in order to deliver food to their stomach. So while a spray to numb the throat to stick a tube into your oesophagus would work..I don't think it would be the same for the trachea. If your conscious you'd be breathing(hopefully, unless your paralysed) so I don't think you'd want a tube down your throat breathing for you. Just some thoughts......i think ER does the "intubated conscious patient" thing for a dramatic effect....:) Thanks for responding!

-- Emma (empatto@hotmail.com), February 22, 2000.

I am in the medical field and my husband is a Nurse Anesthetist. Awake intubations are possible. Like I said before, they are not the most common way. People who are intubated and on ventillators do not have to be paralyzed or unconscious. I have seen and dealt with many patients who are on the ventillator who are very aware of their situation. An awake intubation is used in special situations and emergencies, but there are times when it is indeed done in the real world and not just as a show on tv.

-- bratan (bjones40@bellsouth.net), February 23, 2000.

I've noticed that most of the time when they do an intubation in the ER they use a drug called Sux. Suxamethonium Chloride is a rapid onset, short duration muscle relaxant which is ideal for quick intubations in an trauma case.

-- Mark Tehan (derektehan@aol.com), May 17, 2001.