# spiking the bag?



## newbemt2 (Jul 18, 2016)

I work for a private BLS company and was never formally taught how to spike a bag. I'm also extremely new so I was wondering if medics expect us to do it for them? I was on a call where, in hindsight, I probably should have but was never asked/wouldn't have really known how even if I had been. Again, where I work we're strictly BLS and don't work with medic partners unless they're on scene with us.


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## DesertMedic66 (Jul 18, 2016)

Yes in most system that is expected from EMTs. If you do not know how to do it when on a call *don't do it. *Ask for help instead or have someone else spike the bag that knows how.


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## STXmedic (Jul 18, 2016)

An awesome partner learns to anticipate the needs of his partner. That comes with experience with patients and knowing what they need, and with working with and getting to know your partner and their methods. It sounds like you're limited on the latter, but the former is still in your control.

So with spiking a bag, if you make a patient that is obviously in need of fluids and you expect the medic to want to start fluids, then absolutely, spike a bag. If you're on the fence, then simply ask him if he wants you to spike one. Don't just go setting up bags for every patient though, since most patients don't need fluids.

I'm sure YouTube has a video on how to spike one. It's very simple:
-Unpackage a bag and drip set (there are two main kinds of drip sets, macro and micro. Learn when you would use each, if you even carry both). 
-Pull the tab on the port for the bag. 
-Pull the sheath off the spike of the drip set. 
-Insert spike into port. 
-Squeeze the drip chamber until it's half full.
-Bleed out all of the air from the line.


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## Jim37F (Jul 18, 2016)

Where do you work? Some places spiking the bag is an expected BLS skill, other places don't even think about touching the bag if you're not ALS....

Here in Los Angeles Co it's considered an ALS Assist skill (i.e. cant touch it until the medic asks you to go ahead and spike the bag for them, usually while they're getting the stick). 

It's a fairly easy procedure, but there is a bit of technique to it, especially the follow up (filling the drip chamber, and flushing the tubing to get all the air out without making a big mess....sometimes easier said than done lol)

There's several videos on Youtube similar to this one that'll show you how to do it properly better than I can attempt to explain it here:


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## nightmoves123 (Jul 18, 2016)




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## newbemt2 (Jul 18, 2016)

STXmedic said:


> An awesome partner learns to anticipate the needs of his partner. That comes with experience with patients and knowing what they need, and with working with and getting to know your partner and their methods. It sounds like you're limited on the latter, but the former is still in your control.



We aren't partnered up with medics, we only see them when they're absolutely needed, so it makes it a little harder to know what they expect/need!

Thanks everyone!
It was also a really hectic call, drugged out guy running around on the highway and about 15 state troopers plus 2 engines on scene. I never even thought about getting an IV bag ready, although I knew they would need to set one up since the nasal dose of narcan wasn't working. My friend who showed up on another rig was giving me crap about not doing it so now I'm worried about how dumb I looked.


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## Gurby (Jul 18, 2016)

newbemt2 said:


> It was also a really hectic call, drugged out guy running around on the highway and about 15 state troopers plus 2 engines on scene. I never even thought about getting an IV bag ready, although I knew they would need to set one up since the nasal dose of narcan wasn't working. My friend who showed up on another rig was giving me crap about not doing it so now I'm worried about how dumb I looked.





Spiking a bag is such a tiny, meaningless thing.  I wouldn't worry about it at all.  Definitely don't go playing with the ALS gear unless specifically asked to, and you know what you're doing.

I'm more concerned about the thought process: you thought they would need to set up a bag, because the nasal narcan wasn't working, for your patient who was running around on the highway?  None of that makes any sense!


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## DesertMedic66 (Jul 18, 2016)

Patient running around on scene meets my criteria to not get Narcan


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## newbemt2 (Jul 18, 2016)

Oops, the only thing I've ever seen given using nasal spray, IM, and IV is Narcan so I assumed it had multiple purposes not only for heroin OD's. This guy was probably PCP, so what did the medics give him?

Again, I'm new


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## WolfmanHarris (Jul 18, 2016)

I go through enough lines in a shift I keep one 250ml NS spiked and primed with a lock in. Doesn't take much time but it's one less thing to do, less trash on scene and frees up my partner or myself for other things.


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## WolfmanHarris (Jul 18, 2016)

newbemt2 said:


> Oops, the only thing I've ever seen given using nasal spray, IM, and IV is Narcan so I assumed it had multiple purposes not only for heroin OD's. This guy was probably PCP, so what did the medics give him?



Probably midazolam, haldol or whatever sedative they carry.


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## DesertMedic66 (Jul 18, 2016)

Probably Versed IN.


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## STXmedic (Jul 18, 2016)

newbemt2 said:


> Oops, the only thing I've ever seen given using nasal spray, IM, and IV is Narcan so I assumed it had multiple purposes not only for heroin OD's. This guy was probably PCP, so what did the medics give him?
> 
> Again, I'm new


I honestly wouldn't be surprised if they gave narcan, but like Desert said, it would be highly inappropriate. Hopefully they gave versed or ketamine.


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## newbemt2 (Jul 18, 2016)

STXmedic said:


> I honestly wouldn't be surprised if they gave narcan, but like Desert said, it would be highly inappropriate. Hopefully they gave versed or ketamine.



Ah I see. Thank ya! All I knew was that they would need an IV as well cause this guy was still going crazy after two nasal doses


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## STXmedic (Jul 18, 2016)

And an IV doesn't necessarily mean they need a bag. A bag is for if they need fluid, not just because they need an IV. I'd say close to 80% of my IVs don't have a bag hanging. Most of the time it is just a saline lock (which is something else you can set up if you're on scene)


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## Handsome Robb (Jul 18, 2016)

Dude needed some ketamine. 


Sent from my iPhone using Tapatalk


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## akflightmedic (Jul 18, 2016)

Unspiked bags are great for slapping the patient without leaving a mark...since phone books are more rare these days.


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## luke_31 (Jul 18, 2016)

akflightmedic said:


> Unspiked bags are great for slapping the patient without leaving a mark...since phone books are more rare these days.


Plus having a phone book in the ambulance would look odd.


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## Qulevrius (Jul 22, 2016)

Phone books are so 1990's, use the Thomas Guide !


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## OCemt86 (Jul 22, 2016)

They dosed narcan to an alert ambulatory patient? The f**k do you work at?


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