Advanced ALS stuff?

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O 2

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I was wondering if anybody could list for me some the more progressive interventions that are not commonly found in every system.

Also, what is the status of the surgical cric? is that commonly in most medics scope? I found the new nationals scope model list percutaneous, not surgical crics.

What about RSI?

THanks:)
 
I was wondering if anybody could list for me some the more progressive interventions that are not commonly found in every system.
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Real pain management. You know, for all pain, not just extremity fractures.

Surgical crics are up to your state and medical director to determine. My system allows it, and we have to prove competency yearly (which let's face it, is not nearly enough). However, this is probably one of the more truly lifesaving interventions when done appropritely. If a cric is needed, there is no other way to manage the airway, and the patient will die without one.
 
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Pericardiancentesis
Ultrasound
RSI (even though it's becoming more common)
 
Chest tube
Escharotomy
Surgical cric
central line
Insulin
 
medic417 said:
Yes seriously. Rural areas long transports.
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If that's the case, I'd rather risk complications from an escharotomy than have the pt suffer and die from restricted/no Cx excursion or lose a limb from compartment syndrome in the ext's. Good for them! Just curious, is that within the national scope of practice?
 
O 2 said:
Also, what is the status of the surgical cric? is that commonly in most medics scope? I found the new nationals scope model list percutaneous, not surgical crics.
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Most percutaneous needle cric kits (in my area) are now the "Quik-Trach" system, and it's technically a needle cric but it introduces a 6.0 or a 6.5 ET tube into the trachea so it is just as effective as a surgical cric with out all this scalpel nonsense :P
 
sir.shocksalot said:
Most percutaneous needle cric kits (in my area) are now the "Quik-Trach" system, and it's technically a needle cric but it introduces a 6.0 or a 6.5 ET tube into the trachea so it is just as effective as a surgical cric with out all this scalpel nonsense :P
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Check tube size I believe they are smaller but I may be confused.:wacko:
 
Yeah, that field expedient use of a drip chamber was taught to my class too. Of course, that went along with: You'd better have exhausted all your needle cric kits first...
 
Linuss said:
Medic school... protocols of many of the local EMS agencies... directly from the mouth of a couple of docs...
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After talking to my new medical director, I betcha I could probably get away with it... Which kinda scares me a little
 
Gives me the warm and fuzzies about my surgical cric kit, with a real scapel, trach hook and hemostats. And giving me warm and fuzzies about having to cut is hard....
 
Hell we have been proactively leaving people at home for thirty years, not too many places I know who do that.

Oh and we are also doing RSI and thrombolysis now too.
 
Quik-Trachs are typically a 10g needle. Not nearly the size of a tracheostomy.
 
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