Bagging with BVM while stretcher is in motion

Linuss

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I specifically came to EMS to get more training and information about airway control. And I am wholeheartedly an advocate of camaraderie between Health Care Professionals.
And not cardiology as well?

Airway and cardiology is what we do G!
 

mycrofft

Still crazy but elsewhere
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DOGPILE. RN and ex-EMT here.

I was teaching my nursing instructors about cylinder O2 and BVM's. My nursing cohorts do not know anything about how to actually do scene EMS. It simply is not taught, or taught properly, in nursing school becuase it isn't the usual for a nurse.

Without some way to properly direct the flow like ET etc., BVM's are not much. Better than mouth to mouth. I've seen some real clusterbunnies where someone is trying to BVM and move the pt at the same time, including taping the BVM to the ambuance litter frame and giving it a honk once in a while.

What if you are working with a D ring stretcher/litter? Hope you have one of those neat NATO carrier wagons.

Yeah, ER staff might not have the word you are coming in if it's busy and their commo people fail to get the word to them, or they are too danged busy to hear and remember. Be a good team member and remember that getting excited at that point is pointless
 

8jimi8

CFRN
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And not cardiology as well?

Airway and cardiology is what we do G!
I agree, i left out cardiology, it is my favorite subject. But I had other reasons for being interested in cardiology; however RN's do get great training with cardiology, not as much 12 lead interpretation, but that is just the very smallest bit of cardiology. I had my ACLS, before i ever started studying EMS, so I didn't really feel like I was in a knowledge deficit... see my distinction?

I am VERY exciting about my upcoming paramedic cardiology class this fall. Finally gonna finish up the EMT-I here, hopefully by may.
 

Linuss

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Speaking of bagging in motion, I had to do just that last night.

Transformer blew and houses lost power. One of the houses had a pedi with a trach on a vent, and of course the vent batteries died and the new nurse didn't know what to do so she called us.

I bagged the kid through tiny hallways trying to keep the trach in out to the rig, through knee-deep snow. Talk about an experience.
 

EMSBLONDIE24

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I've been to 2 scenarios while bagging patients and moving.
1- The patient has been intubated and that means a paramedic is with you and your crew. If you are riding an minimum of 2 people, that means 2 people push/guide the stretcher and the remaining one bags. I've bagged while the medic and my partner have pushed the stretcher, as well as had a medic bag and I helped with the stretcher, no biggie.
2- The patient was not intubated and I was bagging (just my lone partner and I) He pulled the stretcher from the foot of the stretcher, and because the seal needed to be maintained, I "rode the rails." In other words, you put both feet on the bottom rail of the stretcher, lean all your weight forward so you are leaning over the patient, leaving both hands free to bag. Your feet shouldn't be touching the ground, "riding the rails" can also be used for CPR while moving into the hospital/ambulance. This worked because we weren't flying down the corridor and our patient was really thin, my weight added onto the stretcher and added stability and prevented us from flying out at the corners.
Hope this helps... ^_^
 

8jimi8

CFRN
1,792
9
38
I've been to 2 scenarios while bagging patients and moving.
1- The patient has been intubated and that means a paramedic is with you and your crew. If you are riding an minimum of 2 people, that means 2 people push/guide the stretcher and the remaining one bags. I've bagged while the medic and my partner have pushed the stretcher, as well as had a medic bag and I helped with the stretcher, no biggie.
2- The patient was not intubated and I was bagging (just my lone partner and I) He pulled the stretcher from the foot of the stretcher, and because the seal needed to be maintained, I "rode the rails." In other words, you put both feet on the bottom rail of the stretcher, lean all your weight forward so you are leaning over the patient, leaving both hands free to bag. Your feet shouldn't be touching the ground, "riding the rails" can also be used for CPR while moving into the hospital/ambulance. This worked because we weren't flying down the corridor and our patient was really thin, my weight added onto the stretcher and added stability and prevented us from flying out at the corners.
Hope this helps... ^_^
Sounds like you got lucky in your scenario, the weight of two people, plus a stretcher is too much for one person if something goes wrong. Who's liability will it be if you over turn your stretcher and fall on top of your patient? I'm not judging, so please don't take offense, just trying to have open dialogue. :)
 

mycrofft

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Linuss, very good! Way to go!

Hopeit turned out well.
 

EMSBLONDIE24

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Sounds like you got lucky in your scenario, the weight of two people, plus a stretcher is too much for one person if something goes wrong. Who's liability will it be if you over turn your stretcher and fall on top of your patient? I'm not judging, so please don't take offense, just trying to have open dialogue. :)
No offense taken, you've made a valid point...
Both patients in the scenarios were elderly females, they were very dainty and didn't weigh much at all. I'm fairly light as well, so weight wasn't an issue. My partner is also a very strong 6ft 3 male, who does most of the lifting on calls.
I'll stress that we were moving pretty slowly, and my partner had one hand on the stretcher rail and one at the end to guide it around the corners. Luckily nothing happened, but of course it's a risky move. Then again, who has ever bagged a patient under ideal conditions? EMS karma... ;) That being said, this situation has only be re-enacted twice so far due to a patient rapidly deteriorating in the ambulance. Other times I've had a paramedic with me.
If I felt the stretcher was unsteady, I'd jump off the bottom rails and help guide it with my body while attempting to keep both hands free. My partner and I also discussed if we ever get a heavier patient and it's just the two of us with a similar scenario, we'd tell the ER we needed a nurse to meet us when we pulled in. Of course, the paramedic scenario is ideal with 3 people.
Hope this clears up any confusion! :)
 
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OHMEDIC

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In my opinion if you have a patient that requires bag valve mask ventilations then you should have additional help at the scene. Engine crew depending on F.D. involvement?
 

wolverine

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Bagging while Stretcher in Motion

Don't know if there's a protocol for it, the way we do it is usually 3 person team 2 to handle the top&bottom of the stretcher the one bagging is standing on the bottom bar of the stretcher and bagging, hope this help
 

rhan101277

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Yeah I hope there is scene help, but sometimes its a transfer or whatever. We run a 2 person truck so sometimes it is just you and your partner. I am sure when I get out of school I will get it with more experience.
 

OHMEDIC

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Yeah I hope there is scene help, but sometimes its a transfer or whatever. We run a 2 person truck so sometimes it is just you and your partner. I am sure when I get out of school I will get it with more experience.
You'll get better at anything with experience, but remember the patient is going to spend more time without ventilations if the cot tips over and your wrestling to recover the situation.
 
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