L2 portfolio: vetn3.2 airway management

Re: L2 portfolio: vetn3.2 airway management

Phrin Vernon RVN — Thu, 25 Mar 2010 21:46:21 GMT

[quote user="Jenny Cook"]

I had my portfolio partialy IV'd and got it back today from college. And one of the things that was noted was airway management.

I had previously helped with a cat c-section and covered resuscitation and airway management of it, which seemed fine, adn i now have few more questions to answer with regards to that.

In the assessor comment section of my IV report it says I should still be assessed on placing ET tubes to support the management of airways in patients (vetn3.2, scope C iv)....

I thought placing ET tubes was level 3 stuff???

Also what else did you use then to cover this particular Scope??

Cheers. x

[/quote]

I did my L2 portfolio many moons ago with the old version, but have just had to be assessed intubating for L3 - and to my understanding for the assesor to mark you off for something, you have to be competant - it can't be a one off lucky shot. When I was a L2 student, it was something I was taught, and was expected to be able to do in an emergency as I worked in a 24hr practice - I have a vivid memory of tubing a crashed border collie on my own at 3am whilst waiting for the vet..eek! Not fun!

Anyway - I think a L2 nurse should be able to tube - its not that difficult with practice, and most vets are happy to let you have a go with routine stuff. My personal rule (same for hitting veins) is that if I can't do it after 2 trys, then ask someone else to do it. If the vet knows you just want to have a go, and will hand over if you can't do it, then there is no reason for them not to let you try. And after 10yrs experince I still have to follow my '2 go's' rule every now and then, as do the qualified staff at work, so don't worry if you can't do it straight away! these things take practice! (pun kinda intended)

Re: L2 portfolio: vetn3.2 airway management

Susan Jackson — Thu, 25 Mar 2010 18:00:49 GMT

[quote user="Jenny Cook"]

I had my portfolio partialy IV'd and got it back today from college. And one of the things that was noted was airway management.

I had previously helped with a cat c-section and covered resuscitation and airway management of it, which seemed fine, adn i now have few more questions to answer with regards to that.

In the assessor comment section of my IV report it says I should still be assessed on placing ET tubes to support the management of airways in patients (vetn3.2, scope C iv)....

I thought placing ET tubes was level 3 stuff???

Also what else did you use then to cover this particular Scope??

Cheers. x

[/quote]

I've assessed students clearing throats on neonates and using dopram which has been fine, i know they prefer you to have something to tube but if you're not competent tubing then you can't be assess as competent.

My suggestion is that you get practise on animals that are undergoing anaesthetics then once your assessor feels you can competently tube a few, you have a professional discussion about maintaing airways and what you would do in an emergency situation so your ABC. Then your assessor refers to an animal you have tubed which is evidence of a 'transfere of skill' , meaning: if you can tube for anaesthetics you can tube during emergency.

Hope you understand this, not always sure i do myself, at least you won't need to worry about next year. Gone is the portfolio!

Re: L2 portfolio: vetn3.2 airway management

Jenny Cook RVN — Thu, 25 Mar 2010 17:39:54 GMT

*bump*

Thanks, think i shall ask a bit more.... but still think its level 3 stuff to be done with regards to portfolio, but also agree it might be something worthwhile in learning as soon as.

Re: L2 portfolio: vetn3.2 airway management

Nicola Smith — Thu, 25 Mar 2010 09:38:57 GMT

Our level 2 has intubated for her portfolio, feel its an important thing to be able to do as you never know when you might need it. She watched first, being shown the anatomy, then started n dogs, then onto cats. She went through a stage of doing most GAs to get confident.

Re: L2 portfolio: vetn3.2 airway management

Juliet Drummond DAVN (med) RVN D32/33 — Tue, 23 Mar 2010 21:32:35 GMT

i have assessed this part many times using the student only assisting with intubation.

the pc (10) in 3.2 states 'assist' the qualified staff. assist = help not actually do the procedure.

i've never had a problem with an iv on it, but again like alot of the current standards it could be interpreted differently by different people.

i do think you should be able to practice and be come competent at intubation as a level 2 nvq student.

Re: L2 portfolio: vetn3.2 airway management

SmegSlayer — Tue, 23 Mar 2010 20:39:37 GMT

i had to intubate for that bit if my level 2. pester vets to show u intubating. have someone else hold the animal (go for a nice size dog like a lab or retreiver to start) and get them to show u the anatomy of the throat so u know exactly where the tube is supposed to go. watch a couple like this and then try for yourself. always check it afterwards coz there's always 1 that goes down the oesophagus. once your confident there try brachycephalic breeds and then move onto cats. take your time to visualise the throat properly- u think u haven't got long with an induced animal but time moves differently when you feel under pressure.

i really enjoy tubing- i get a good sense of satisfaction, especially when the vets keep getting it wrong!

Re: L2 portfolio: vetn3.2 airway management

Kim Buckley — Tue, 23 Mar 2010 17:53:13 GMT

I don't know why vets are so funny about vn's tubing things. The vets I work with are really good and the sooner you get doing it the better. If you leave it for ages without doing it then you will build it up in your head that it's harder than it is.

Just remember that dogs and cats are completely different and require different techniques.

Re: L2 portfolio: vetn3.2 airway management

Vicky RVN — Tue, 23 Mar 2010 17:48:49 GMT

[quote user="Vicky VN"]

[quote user="Vicky SVN"]

Like i said on msn, i'm pretty damn sure you shouldn't have to do it for level 2! Well, i didn't do it for mine and it passed Not sure what i did to cover it though...not got my portfolio here to look!

[/quote]

I think it's good to start at level 2, hopefully you'd not need to be under pressure to insert an ET in an emergency at that stage but if you were confident with them it will take pressure off (as well as being extremely useful in an emergency situation )

I've worked in a few places where the students only place ET tubes to get their portfolios marked off and they have no confidence in placing them in a 'normal' situation nevermind an emergency.

[/quote]

Yeah i agree to start at level 2 wouldn't be a bad thing...now getting close to level 3 exams and still not tubed anything (except once doing a pts'd dog). I'll have to start pestering more lol! Def don't want to practice on cats yet though, want to feel confident with dogs first!

Re: L2 portfolio: vetn3.2 airway management

Maisy — Tue, 23 Mar 2010 17:40:02 GMT

[quote user="Jenny Cook"]

no, never intubated before in 3 years being in practice and then actually on training at college since sept.... should i have learned then by now? Is that bad that ive never done it? lol

[/quote]

No not bad Would definitely be worth getting some practice though now. Have a word with a vet/nurse and when you have an anaesthetised patient, get someone to go through it with you and go from there. Large dogs tend to be easier but practice lots with cats as often its the cat RTAs you intubate the most!

Re: L2 portfolio: vetn3.2 airway management

Maisy — Tue, 23 Mar 2010 17:37:52 GMT

[quote user="Vicky SVN"]

[/quote]

I've worked in a few places where the students only place ET tubes to get their portfolios marked off and they have no confidence in placing them in a 'normal' situation nevermind an emergency.

Re: L2 portfolio: vetn3.2 airway management

Jenny Cook RVN — Tue, 23 Mar 2010 17:36:13 GMT

[quote user="Vicky VN"]

No you need to include it for Level 2 as well. Have you intubated before?You can either write up a case where you intubated in an emergency or have a assessor/witness statement to say you've done one on an anaesthetised patient once you are confident with them.

[/quote]no, never intubated before in 3 years being in practice and then actually on training at college since sept.... should i have learned then by now? Is that bad that ive never done it? lol

Re: L2 portfolio: vetn3.2 airway management

Vicky RVN — Tue, 23 Mar 2010 17:33:34 GMT

Re: L2 portfolio: vetn3.2 airway management

Maisy — Tue, 23 Mar 2010 17:33:30 GMT