Advanced Airway: unconscious to conscious

[lightsandsirens5]

option 3 is the only one that is 100% incorrect.

the way I'm reading option one is call for a medic intercept and have a medic give a paralytic, not that a medic is already on board and ask them to give it. That could be correct depending on the situation.

Calling medical control is always the correct answer if it's an option on the basic level test.

restraining the patient is a good choice as well depending on local restraint protocols.


To the OP a few tricks on the NR test. If BSI/ scene safety is an option, that's the correct answer. If ensure ABC's are in tact is an option that is the correct answer. If contact med direction for orders is an option that is the correct answer. If any combination of those exist, choose all of the above.

Well ok, that make sense. I guess I assumed that the pt was gagging. I see that the OP dosen't say that though, so............

 

[Sasha]

Well ok, that make sense. I guess I assumed that the pt was gagging. I see that the OP dosen't say that though, so............

Let them gag. We do not extubate, that's the hospital's job

Of course, there's always option 5, knock them back out with an O2 cylinder.


Sarcasm, by the way.

 

[marineman]

Administer 200cc of clipboard, doesn't leave as big of a mark as an O2 tank

 

[daedalus]

So, you want to put the entire flight crew at risk (You've heard all those stories about them crashing!) for something that could've gone by ground?

Not to mention tack on the helicopter bill which I imagine is significantly more than an ambulance bill to their final total.

And I think there are fewer helicopters then there are ALS ground units.

Why the :censored::censored::censored::censored: would this guy want to fly a tubed patient? I transport them every shift on my CCT! Talk about waste and risk>>benefit!

 

[piranah]

I can intubate as a basic in the field in cardiac arrest situations...I've successfully intubated 10 pts.(in hospital during medic clinical)...if i had a pt awake enroute i would calmly explain to them what happened,and advise them not to pull the tube.....I ALSO would be calling for ALS intercept due to the fact im not working a BLS code.and by the way.....if you remove that tube incorrectly....you better deflate that cuff,listen for air passing if you don't....your F'd....when you remove it and suction and you hear upper resp stridor hang on to your socks and re-intubate because you'll be F'd ..(with a little jingle) ** put em' in a little box, cover em' over with dirt and rocks**..

 

[MSDeltaFlt]

Why the :censored::censored::censored::censored: would this guy want to fly a tubed patient? I transport them every shift on my CCT! Talk about waste and risk>>benefit!

The reason is why the pt was tubed in the first place. Also, there are areas that do not have CCT's. They either have ALS 911 units or HEMS.

Responding from someone else's post earlier, just because a pt can extubate themselves does not mean they are ready to be extubated. There are those pts, Vent and I have seen them for years, that can extubate themselves and still need to stay on the vent. For example, TBI's, CVA's, or any other pt with a significant ALOC. Sometimes all they have is a momentary burst of energy to pull the tube. That's about it (said like Austin Powers in "The Spy who Shagged Me").

Which is why you need personnel (not just one person) with equipment and meds and protocols to safely transport these pts. Also bare in mind that there is a growing trend to keep from having to paralyze as many of these pts as possible. That requires a very judicious amount of sedation, very fine tuned tweaking of the specialized vents and settings, and very, very close monitoring as well as the knowledge, and training, and experience that comes with them all.