# Bite sticks



## Explorer127 (Apr 8, 2008)

I was always taught that people who are having seizures should just be left alone to seize, but i find bite sticks on a bunch of ems store websites.....

So, the question is...do you or do you not use the bite stick..I always knew that you're not supposed to, but if you weren't supposed to, why would they sell them?


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## Ridryder911 (Apr 8, 2008)

Why they sell them? Some idiot bought a lot of them and now are trying to get rid of them.  There are enough whackers that buy them. Personally have not seen them for decades, they used to be popular that every EMT would carry in their scissor pouch. 

The treatment is attempt to prevent injuries, in other words .. leave them alone and protect them. I have NEVER seen a total lacerated tongue caused by seizures. I have seen fractured teeth, broken dentures caused by poor rescuers placing objects in their mouth. 

Some have used a portion of an oral airway for a bite block, but again monitoring the patient. 

R/r 911


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## Gbro (Apr 8, 2008)

We used the wedge, and about anything (including fingers) we could to help open an airway(clear path around the teeth), but with nasal airways being a basic skill has made it so much easier to manage a clenched jaw.
I would get my hands slapped often as other crew members were uncomfortable with seeing fingers in an airway. I never got bit and never planned on it, but wouldn't hesitate to do every thing i could to maintain an airway. On the rare occasion when i saw someone else stick fingers into a pt's mouth it did bother me. Funny how that works.


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## Ridryder911 (Apr 8, 2008)

Gbro said:


> We used the wedge, and about anything (including fingers) we could to help open an airway(clear path around the teeth), but with nasal airways being a basic skill has made it so much easier to manage a clenched jaw.
> I would get my hands slapped often as other crew members were uncomfortable with seeing fingers in an airway. I never got bit and never planned on it, but wouldn't hesitate to do every thing i could to maintain an airway. On the rare occasion when i saw someone else stick fingers into a pt's mouth it did bother me. Funny how that works.



Your kidding right? I would do more than slap your hands, I can assure you that would be the last time you responded. Sorry, never used mouth screws, bite sticks/blocks, wallets, spoons, or fingers in the mouth. There is *NO NEED IN PLACING ANYTHING INTO A SEIZURE PATIENT's MOUTH!* Why cause more obstruction?  The jaw clenches and * occasionally* will have spastic or biting movements. No, it is doubtful they will bite their tongue off and will not swallow their tongue (both are great urban legends). Remember, the tongue is a muscle and yes can be stitched and repaired. No, no one yet has ever swallowed their tongue.. it is attached.


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## Explorer127 (Apr 8, 2008)

about putting fingers in the pt's mouth...that's probably not a very good idea...a seizure pt has no control of their muscles, and they can bite your finger off...


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## ffemt8978 (Apr 8, 2008)

Never put anything in a patient's mouth that you don't want to lose.


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## tydek07 (Apr 8, 2008)

Very true, very true.


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## Epi-do (Apr 8, 2008)

omarsobh said:


> I always knew that you're not supposed to, but if you weren't supposed to, why would they sell them?



To get the peanut butter out of the jar when you realize you left your knife at home?

You could always use them to splint something really small.......you know.....like a finger.......


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## mikie (Apr 8, 2008)

The only use I've heard for the bite stick is when aiding with administration of oral glucose, in between the cheek & gums

Is this correct?


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## Ridryder911 (Apr 9, 2008)

mikie333 said:


> The only use I've heard for the bite stick is when aiding with administration of oral glucose, in between the cheek & gums
> 
> Is this correct?



Actually a tongue blade can do the same thing for a a lot less expense (free). Bite sticks, used to be commonly used in hospitals for seizure patients. 

R/r 911


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## Ops Paramedic (Apr 9, 2008)

Dentists also needs work!!  (just kidding)

Why they are still being manufactured?  Someone is still buying them.  There is absolutely no need to stick any form of bite block into the mouth. The patient has paid good money for that seizure, let him have it.  

If you mess around the patient's mouth to stick something down, you run at great risk of losing your fingers, and with THAT causing a real obstruction, as Rid mentioned.  Should you want to do anything for the patient's airway, just turn him lateral.


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## Topher38 (Apr 9, 2008)

mikie333 said:


> The only use I've heard for the bite stick is when aiding with administration of oral glucose, in between the cheek & gums
> 
> Is this correct?



I was only taught 2 reasons to use a bite stick.

-Oral glucose
-My instructor said we could use it for holding down the tongue when inserting an OPA but Isnt that why we Put it in upside down and rotate 180 degrees?


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## rmellish (Apr 9, 2008)

Epi-do said:


> You could always use them to splint something really small.......you know.....like a finger......



Thats the only time I've seen it used. Still on every one of our trucks though...(shrugs)


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## mikie (Apr 9, 2008)

Topher38 said:


> -My instructor said we could use it for holding down the tongue when inserting an OPA but Isnt that why we Put it in upside down and rotate 180 degrees?



I was taught similar but just for peds/infants: insert OPA at normal angle and use bite stick to depress the tongue while advancing the OPA.  

Adults: 180 degree insertion 

Thoughts?


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## Arkymedic (Apr 9, 2008)

Ridryder911 said:


> Why they sell them? Some idiot bought a lot of them and now are trying to get rid of them. There are enough whackers that buy them. Personally have not seen them for decades, they used to be popular that every EMT would carry in their scissor pouch.
> 
> The treatment is attempt to prevent injuries, in other words .. leave them alone and protect them. I have NEVER seen a total lacerated tongue caused by seizures. I have seen fractured teeth, broken dentures caused by poor rescuers placing objects in their mouth.
> 
> ...


 
Rid you don't carry them on the trucks there? I thought we had to have 4 for state inspection according to our checkoff sheets?


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## Ridryder911 (Apr 9, 2008)

I hope not, we just got inspected yesterday. I believe we tell them we use the oral airways..I know we don't have the bite sticks..

R/r 911


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## synchromedic (Apr 9, 2008)

New Jersey requires them on all ambulances for inspection. 

They work great to break ice on the windshield when your truck cant carry an ice scraper because it can be considered a weapon.


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## BruceD (Apr 9, 2008)

synchromedic said:


> They work great to break ice on the windshield when your truck cant carry an ice scraper because it can be considered a weapon.



Holy cow, is this how far we've degraded ourselves, ice scrapers as weapons... geesh


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## tydek07 (Apr 9, 2008)

synchromedic said:


> New Jersey requires them on all ambulances for inspection.
> 
> They work great to break ice on the windshield when your truck cant carry an ice scraper because it can be considered a weapon.




(because it can be considered a weapon), now that is sad. What have things come to?


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## Jon (Apr 9, 2008)

Bite sticks are like a lot of other things in EMS... they seemed like a good idea at the time... there was no research that showed they were needed or worked... Same thing with MAST Pants and helicopters 

Becuase they "seemed like a good idea" lots of places still have them on the required list for stocking rigs... even though they aren't in the protocols anymore. (The left hand doesn't know what the left is doing).

Jon


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## emtwacker710 (Apr 9, 2008)

I've been told recently that they are considered by some providers to be an airway obstruction, I've always been taught to let a seizing pt. seize, just move objects away from them.


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## Ridryder911 (Apr 10, 2008)

Jon said:


> Bite sticks are like a lot of other things in EMS... they seemed like a good idea at the time... there was no research that showed they were needed or worked... Same thing with MAST Pants and helicopters
> 
> Becuase they "seemed like a good idea" lots of places still have them on the required list for stocking rigs... even though they aren't in the protocols anymore. (The left hand doesn't know what the left is doing).
> 
> Jon



Be careful, actually studies did not state they were not needed or worked. The studies showed that PASG did not change the outcome, good or bad (neither would a thoracic surgeon on those cases studied). Helicopters does provide rapid transport for those outside metro areas, and are validated as a good thing ; both if used properly. It is helo's are not needed in downtown areas or where rapid transport is not warranted or needed. 

p.s. : watch for the return of PASG. New studies, are validating the return in a different procedure and perimeters. I just attended a PHTLS/IHTLS Instructor up-date, and some new things are being considered with all the recent trauma care that has been performed lately. 

R/r 911


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## Jon (Apr 10, 2008)

Ridryder911 said:


> Be careful, actually studies did not state they were not needed or worked. The studies showed that PASG did not change the outcome, good or bad (neither would a thoracic surgeon on those cases studied). Helicopters does provide rapid transport for those outside metro areas, and are validated as a good thing ; both if used properly. It is helo's are not needed in downtown areas or where rapid transport is not warranted or needed.
> 
> p.s. : watch for the return of PASG. New studies, are validating the return in a different procedure and perimeters. I just attended a PHTLS/IHTLS Instructor up-date, and some new things are being considered with all the recent trauma care that has been performed lately.
> 
> R/r 911


Cool Rid... I was just using those as examples.

It would be intresting to see the return of the MAST Pants.
But I'm in PA. By the time it is in the protocols... it would be out of style again


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## Ridryder911 (Apr 10, 2008)

Your points were very valid, we definitely need to be sure to base our treatment modalities upon good clinical & scientific evidence. Part of the problem, the evidence keeps changing, thus the reason to keep abreast of the current studies. 


R/r 911


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## skyemt (Apr 10, 2008)

Not sure why there is such a negative bias towards helicopters these days...

where i am, trip to the trauma center via helicopter is about 15 minutes, instead of 50 minutes on the ground...

yet i see so many who claim they "don't work"...

i can only assume it's due to overuse in more metro areas?


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## Pittsburgh Proud (Apr 10, 2008)

Ridryder911 said:


> Why they sell them? Some idiot bought a lot of them and now are trying to get rid of them.  There are enough whackers that buy them. Personally have not seen them for decades, they used to be popular that every EMT would carry in their scissor pouch.
> 
> The treatment is attempt to prevent injuries, in other words .. leave them alone and protect them. I have NEVER seen a total lacerated tongue caused by seizures. I have seen fractured teeth, broken dentures caused by poor rescuers placing objects in their mouth.
> 
> ...




Man I recall those green things from the 80's you made me laugh we all did carry them with our shears... You are exactly right.


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## Pittsburgh Proud (Apr 10, 2008)

skyemt said:


> Not sure why there is such a negative bias towards helicopters these days...
> 
> where i am, trip to the trauma center via helicopter is about 15 minutes, instead of 50 minutes on the ground...
> 
> ...





I'm sure Rid can tell you, years ago we would only fly true truma cases anymore we seem to fly them if the have a hang nail...  Seems it's the thing to do.


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## BossyCow (Apr 10, 2008)

In first aid I've always taught the two rules of Seizure treatment.. remove all obstacles, and don't become an obstacle.


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## mikie (Apr 10, 2008)

Wow, what a considence:

I was restockign the ambulance (this morning- 3AM after a call) and in the supply room found an old bite stick!  It said "seizure stick" and it was in a torn plastic wrap bag.  Looked ancient!


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## Jeremy89 (Apr 10, 2008)

mikie333 said:


> Wow, what a considence:
> 
> I was restockign the ambulance (this morning- 3AM after a call) and in the supply room found an old bite stick!  It said "seizure stick" and it was in a torn plastic wrap bag.  Looked ancient!



Keep it....it may be a collector's item one day 

J


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## paramedix (Apr 10, 2008)

No No No...

We teach the public to stay clear of a "seizing-mouth" and continiously try and teach them not to push that spoon down their mouths... but hey, why don't we just throw away the bite stick and use a spoon!?

As mentioned, you cannot swallow your tongue... it can fall back, therefore turn lateral. 

We don't carry bite sticks at all...no need for it.


			
				Ops Paramedic said:
			
		

> Why they are still being manufactured? Someone is still buying them.


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## Pittsburgh Proud (Apr 10, 2008)

mikie333 said:


> Wow, It Looked ancient!




It sure is.....


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## crash_cart (Apr 10, 2008)

Ridryder911 said:


> Why they sell them? Some idiot bought a lot of them and now are trying to get rid of them.  There are enough whackers that buy them.
> R/r 911



You can even find a few on eBay.


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## Pittsburgh Proud (Apr 10, 2008)

crash_cart said:


> You can even find a few on eBay.



Ya think could figure out something cool to do with them... I still see them around also, even hospitals still have them.


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