# Yep, it's an EZ-IO.



## abckidsmom (Feb 8, 2011)

It's like the easy button at staples.

Again proving that the tasks of EMS can be taught to anyone, but the indications, thought processes and patient management are where the meat is.

It. just. doesn't. matter. what cool procedures your department has.  It doesn't matter what progressive new thing is going on.  IT'S YOUR BRAIN that has to be the progressive part on the ambulance.  Everything else follows.

(He's 3, BTW, and if it's a power tool, he's an expert.)


----------



## usalsfyre (Feb 8, 2011)

^^^^^^   

Thanks, you just made my night.


----------



## medicRob (Feb 8, 2011)




----------



## Shishkabob (Feb 8, 2011)

I did one on a patient just yesterday.


How many has your son done on real people?!  Huh?!  Who's the monkey now!!! h34r:


----------



## abckidsmom (Feb 8, 2011)

Linuss said:


> I did one on a patient just yesterday.
> 
> 
> How many has your son done on real people?!  Huh?!  Who's the monkey now!!! h34r:



His dad did one on a patient Saturday.  That company is doing well.

Sadly, VA law prohibits people under 16 from riding in a licensed EMS vehicle, so he's going to have to wait a while.

If we find any more guys under cars when we're out and about though, I'm going to put this boy to work.  He shows extreme composure under stress.


----------



## abckidsmom (Feb 8, 2011)

Especially if he's allowed to have his blankie with him.


----------



## usalsfyre (Feb 8, 2011)

abckidsmom said:


> Especially if he's allowed to have his blankie with him.



He's similar to Linuss in that regard .


----------



## Aidey (Feb 8, 2011)

usalsfyre said:


> He's similar to Linuss in that regard .



+1

lol


----------



## johnrsemt (Feb 9, 2011)

we had a medic who had taught his 7 y/o daughter how to do IV's.  she was pretty good at it.


----------



## lampnyter (Feb 9, 2011)

I learned to intubate! Wheres my cookie?


----------



## medicRob (Feb 9, 2011)

lampnyter said:


> I learned to intubate! Wheres my cookie?



WARNING: VERY GRAPHIC IMAGE: http://www.documentingreality.com/forum/attachments/f149/78705d1249167796-gunshot-chin-suicide-attempt-photo22.jpg

No cookie, instead you get a chance to intubate a perfectly intact airway with gross facial deformity.


----------



## lampnyter (Feb 9, 2011)

Psht thats easy


----------



## citizensoldierny (Feb 9, 2011)

lampnyter said:


> Psht thats easy



Just follow the bubbles. I would definitely need a red bag for myself if I was going to be trying to intubate this guy though:wacko:


----------



## abckidsmom (Feb 9, 2011)

medicRob said:


> WARNING: VERY GRAPHIC IMAGE: http://www.documentingreality.com/f...7796-gunshot-chin-suicide-attempt-photo22.jpg
> 
> No cookie, instead you get a chance to intubate a perfectly intact airway with gross facial deformity.



I know several medics who'd fall all over themselves to RSI that guy and cric him.


----------



## Shishkabob (Feb 9, 2011)

Shoot, I'd go for the cric, claiming "inability to recognize airway landmarks due to gross trauma and massive bleeding" and that I "was not comfortable in the patients ability to maintain their own airway"


----------



## Epi-do (Feb 9, 2011)

Linuss said:


> Shoot, I'd go for the cric, claiming "inability to recognize airway landmarks due to gross trauma and massive bleeding" and that I "was not comfortable in the patients ability to maintain their own airway"



Eh...  Doing a cric is over rated.  If you remove the stress of the situation, the actual procedure is pretty simple.  At least I thought so...


----------



## medicRob (Feb 9, 2011)

This was actually a real patient, he was an 18 year old male who attempted suicide by placing a gun to his chin and pulling the trigger. The first time I saw this patient was in a Difficult Airways lab where we were going over various supplementary techniques in advanced airway management such as Mallampatti airway classification, thyromental distance, etc. 

I remember specifically the trauma team was standing behind him formulating a plan rather than just going in head on all at once. One of the reasons for using this picture was because as we have all seen, blood and gore can often distract even the best paramedic.. For instance, one would look at this image and think oh my God, there is no way we are going to get anything other than a cric. However, this is not the case. You can't tell all that well here but you could from the other pictures of this patient that were part of that lecture (cant seem to find them at the moment) that the patient's airway at least from direct observation the team determined that all of the structures within his neck and oropharynx were intact. As such, they intubated this patient, surprisingly without very much difficulty (Obviously swelling is a definite concern).. 

(*WARNING THE PICTURE BELOW IS EXTREMELY GRAPHIC.*, I DECIDED TO LINK IT INSTEAD OF POSTING IT AS AN IMG BECAUSE THAT IS HOW THE MODS PREFER I POST IT.)


http://www.daviddsemsheadquarters.com/files/gunshot_to_face_self_inflicted.JPG

This picture kind of gives you a better view for the purposes of a mallampatti classification. However, it was not the image I wanted to show you where it the camera was right up on it. Anyways, you can't always judge a book by its cover. 

I will try to find the original study and post the abstract for you guys to take a look at.


----------



## reaper (Feb 9, 2011)

That picture is old one. I seen the same exact picture in a airway class about 8 years ago. You can clearly see how easy it would be to intubate that Pt. 

Rob is right. They used it to show students not to assume the worst and always assess your Pts situation.


----------



## abckidsmom (Feb 9, 2011)

medicRob said:


> This was actually a real patient, he was an 18 year old male who attempted suicide by placing a gun to his chin and pulling the trigger. The first time I saw this patient was in a Difficult Airways lab where we were going over various supplementary techniques in advanced airway management such as Mallampatti airway classification, thyromental distance, etc.
> 
> I remember specifically the trauma team was standing behind him formulating a plan rather than just going in head on all at once. One of the reasons for using this picture was because as we have all seen, blood and gore can often distract even the best paramedic.. For instance, one would look at this image and think oh my God, there is no way we are going to get anything other than a cric. However, this is not the case. You can't tell all that well here but you could from the other pictures of this patient that were part of that lecture (cant seem to find them at the moment) that the patient's airway at least from direct observation the team determined that all of the structures within his neck and oropharynx were intact. As such, they intubated this patient, surprisingly without very much difficulty (Obviously swelling is a definite concern)..
> 
> ...



My biggest concerns would be securing the tube and how much the bleeding would increase when you lay him down.  Certainly the time for that is coming, but I would imagine the best spot for controlling this guy's problem is a really controlled, prepared ER with ENT, Neuro, and anesthesia all standing right there with their difficult airway cart and cautery tools.


----------



## medicRob (Feb 9, 2011)

abckidsmom said:


> My biggest concerns would be securing the tube and how much the bleeding would increase when you lay him down.  Certainly the time for that is coming, but I would imagine the best spot for controlling this guy's problem is a really controlled, prepared ER with ENT, Neuro, and anesthesia all standing right there with their difficult airway cart and cautery tools.



Standing around him are several teams including our heroes in Anaesthesia. 

Here is the original study: 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700575/


They used the light wand, it was an easy intubation which they got on the first attempt according to the team.


----------

