Intubating during a Code

I used to be terrified of codes. Some of the time, it's nothing serious, a precaution, a false alarm. But other times, it's acute respiratory failure, altered mental status, asystole. As the anesthesiologist, I have to figure out whether an airway needs to be secured and do it. Even though I feel pretty comfortable about intubating in the operating room, emergency situations are scary. I have to slow myself down; even though I am anxious to get the tube in, doing so without being prepared can be disaster. Like procedures out of the operating room, my environment is completely different; I have to check all the equipment, make sure I have things I take for granted like suction. I can't count on the people nearby to know what I need or how to help. I can't position the patient optimally. I don't have a lot of time to learn about the patient but have to select appropriate drugs and doses. Luckily the floor intubations at Valley have not given me unexpected difficulty. Most of them have been for respiratory failure, but all have allowed me five or ten minutes to set up everything as I need it. I always have supervision and backup. It is a satisfying challenge and I'm feeling more and more comfortable with it.