The nurse injected the paralytic agent, and in less than thirty seconds, John Doe’s muscles began to twitch—first the larger muscle groups of the arms and legs, then the facial musculature. After a few moments the twitching stopped, a sign that the patient was now fully paralyzed.
Higgins opened John Doe’s mouth, inserted a laryngoscope, and easily exposed the vocal cords. He slid the endotracheal tube between the pearly-white cords, advanced it about three centimeters into the trachea and inflated the cuff at the end of the tube, forming an airtight seal.
“Well done,” Porter said.
Well done—two words that qualified Higgins’ night as a major success. He had intubated an unstable trauma patient on the first try, even with the man’s head strapped to a backboard, a feat that will be remembered by his chief resident. He stepped back and stood triumphantly as Porter took over: “Bag him until his O-2 sat is up, then get him on the ventilator. Run in two units of O-neg as soon as it gets here. Have radiology shoot his spine so we can get him off this board.”
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