EMT Tricks of the trade
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EMTelite
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are you IFT or 911?
Exactly, you have experience with one company. My experience in Riverside is about a year old, but, AMR was computer; Mission was paper; Lynch, while based in OC worked Riverside, and they were paper.
As far as Los Angeles County, I think only Shaffer is on computer, I know AMR and Care are still on paper.
It really does differ from County to County. In Colorado Springs, AMR operates via computer (Typically, a laptop is given to both the Basic and the Medic) and from speaking with some Medics in Denver that I know, they're running on computer as well.
However, I was in Larkspur for The Rennaisance Festival last Summer and broke off from my crowd to chat with Fire and the Stand-by's they had out there (Good way to piss off a girlfriend, by the way.
) and they were all still operating on paper. I mean, Larkspur isn't huge, but it isn't tiny either.
My conclusion, if it's not a major city, it's kind of a crap shoot as to what they're running. Buuuuut, I've been wrong before.
However, I was in Larkspur for The Rennaisance Festival last Summer and broke off from my crowd to chat with Fire and the Stand-by's they had out there (Good way to piss off a girlfriend, by the way.
) and they were all still operating on paper. I mean, Larkspur isn't huge, but it isn't tiny either. My conclusion, if it's not a major city, it's kind of a crap shoot as to what they're running. Buuuuut, I've been wrong before.
JPINFV
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...and if you don't change gloves then there's no point in wearing them due to the amount of cross contamination.
notmeofficer
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Pressure point during compression wrap
Ok.. I like this one and it works well in the field...
ALRIGHT.. REVIEW
4 steps of bleeding control
(PPE/Scene safe of course)
1) Direct pressure
2) Elevation
3) Pressure point
4) Tourniquet
Obviously there are sub steps and treating for shock//
One trick I learned was during the compression wrap (4 x 4s// more 4 x 4s.. compression wrap)... after you make a wrap or two make a twist in your kerlex as you come over the top of the wound.. the twist acts as a pressure point over the affected area.. also a good way to tighten the dressing if it is too loose.. which as we know NEVER happens.. at 2 am in the morning on some country road in the snow.. ever,,,,
Ok.. I like this one and it works well in the field...
ALRIGHT.. REVIEW
4 steps of bleeding control
(PPE/Scene safe of course)
1) Direct pressure
2) Elevation
3) Pressure point
4) Tourniquet
Obviously there are sub steps and treating for shock//
One trick I learned was during the compression wrap (4 x 4s// more 4 x 4s.. compression wrap)... after you make a wrap or two make a twist in your kerlex as you come over the top of the wound.. the twist acts as a pressure point over the affected area.. also a good way to tighten the dressing if it is too loose.. which as we know NEVER happens.. at 2 am in the morning on some country road in the snow.. ever,,,,
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EMTelite
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brillian
^^ ^^^^^^^^^ lol
if it is too loose.. which as we know NEVER happens.. at 2 am in the morning on some country road in the snow.. ever,,,,
^^ ^^^^^^^^^ lol
mycrofft
Still crazy but elsewhere
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That's the drawback to Medirip or Coban
In the wet they don't stick as well if at all, but still fast for applying tight and compressive dressings. Good on you for not going to those combine ABD pads.
In the wet they don't stick as well if at all, but still fast for applying tight and compressive dressings. Good on you for not going to those combine ABD pads.
NRNCEMT
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Here's a blood pressure cuff tip for you guys, you can use a manual BP cuff as a tourniquet to slow a gush/steady stream to a trickle.
mycrofft
Still crazy but elsewhere
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Also BP cuff to pressurize an IV bag.
Watch those flow rates, though!:unsure:
Watch those flow rates, though!:unsure:
Shishkabob
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Been noted a lot, but you should also know to keep an eye on it as it will not be a long term solution--- air will leak out.
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EMTelite
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maybe Im seeing it in a wierd way
Just a question, has anyone used the blow by technique alot? doesnt seem like it is very practical but then again i am not working in the field yet so I wouldnt know just want to see what you guys think
Just a question, has anyone used the blow by technique alot? doesnt seem like it is very practical but then again i am not working in the field yet so I wouldnt know just want to see what you guys think
Afflixion
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Well you've never had to give O2 to a small child then have you? it is not the most efficient way to give O2 to a Pt but about 80% of small children will not keep a non-rebreather or a nasal cannula on so it's best to give them control of it to the children or their parents/guardians and tell the child to put it infront of his/her mouth so they can breathe better... It helps alot but no it is not very effective but some O2 is better then none.
I have used it a number of times ... the goal is to enrich (increase the oxygenation) of the air around the mouth and nose of the child. Even if there is no NC or Ped NRB, just O2 tubing pointed at the child's face is an improvement.
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EMTelite
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Ok yeah that gives me a better understanding and like I said I have not been out on the field yet so I will learn that
mycrofft
Still crazy but elsewhere
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Hypeventilation?
Once yo ahve made sure you are not seeing MI, PE, or other "terrible nevergetover", some measures to address this are readily at hand.
1. Get the pt talking. This causes a break in the inhalations. It can also help reassure the pt. Ask them questions.
2. Have the pt pull up their shirt or blouse a little, and breathe/rebreathe the air inside which is warm, moist and quickly oxygen depleted. (Use commonsense, this works poorly with swimwear except maybe in Iran).
3. Continue to monitor, and make darn sure they are not hypertventilating because they are having an MI and are worreid etc. Treat the pt not the label.
Once yo ahve made sure you are not seeing MI, PE, or other "terrible nevergetover", some measures to address this are readily at hand.
1. Get the pt talking. This causes a break in the inhalations. It can also help reassure the pt. Ask them questions.
2. Have the pt pull up their shirt or blouse a little, and breathe/rebreathe the air inside which is warm, moist and quickly oxygen depleted. (Use commonsense, this works poorly with swimwear except maybe in Iran).
3. Continue to monitor, and make darn sure they are not hypertventilating because they are having an MI and are worreid etc. Treat the pt not the label.
vquintessence
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Once yo ahve made sure you are not seeing MI, PE, or other "terrible nevergetover", some measures to address this are readily at hand.
1. Get the pt talking. This causes a break in the inhalations. It can also help reassure the pt. Ask them questions.
2. Have the pt pull up their shirt or blouse a little, and breathe/rebreathe the air inside which is warm, moist and quickly oxygen depleted. (Use commonsense, this works poorly with swimwear except maybe in Iran).
3. Continue to monitor, and make darn sure they are not hypertventilating because they are having an MI and are worreid etc. Treat the pt not the label.
Too funny!
mycrofft
Still crazy but elsewhere
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Here's a tip: slivers.
STEP ONE: drip on Betadine if they are not allergic. Makes slivers visible, and if you fail to remove all or part of it, the betadine tends to slide down along the foreign object and disinfect along the way.
STEP TWO: use SQUARE TIP forceps like eyebrow tweezers, not sharp tip ones named "splinter forceps".
STEP THREE: If forceps can't do it, use a hypodermic needle, at least 18 gauge. Very sharp, will not bend like a # 11 blade, and unlike sewing needles it had two sharp edges as well as a tip.
STEP FOUR: If you can't get it out, and it needs to be gotten out, dress with betadine (no ointments) and send in. REMEMBER TO ASK ABOUT TETANUS STATUS.
STEP ONE: drip on Betadine if they are not allergic. Makes slivers visible, and if you fail to remove all or part of it, the betadine tends to slide down along the foreign object and disinfect along the way.
STEP TWO: use SQUARE TIP forceps like eyebrow tweezers, not sharp tip ones named "splinter forceps".
STEP THREE: If forceps can't do it, use a hypodermic needle, at least 18 gauge. Very sharp, will not bend like a # 11 blade, and unlike sewing needles it had two sharp edges as well as a tip.
STEP FOUR: If you can't get it out, and it needs to be gotten out, dress with betadine (no ointments) and send in. REMEMBER TO ASK ABOUT TETANUS STATUS.
mycrofft
Still crazy but elsewhere
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About asking for tetanus status...
Never say "Is your tetanus shot current?", nor "When was your last tetanus shot?".
Ask "Do you REMEMBER when you had your latest tetanus immunization?". They will waffle and then admit "No" if you tell them most adults can't really remember.
If they say "YES", ask when where and why.
Never say "Is your tetanus shot current?", nor "When was your last tetanus shot?".
Ask "Do you REMEMBER when you had your latest tetanus immunization?". They will waffle and then admit "No" if you tell them most adults can't really remember.
If they say "YES", ask when where and why.
A140160
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Blow by
Do you guys use an NRB when doing blow by? We've found these really cool things that work wonders for us. They're these rubber teddy bear like toys about 4 inches large, with a perforated space in the stomach (Think a care-bear with a old fashioned telephone mouthpiece in the center). Kids tend to hold onto it better, even try to eat it... (And MAN to they drool...) O2 comes through the holes. Pretty sweet.
Do you guys use an NRB when doing blow by? We've found these really cool things that work wonders for us. They're these rubber teddy bear like toys about 4 inches large, with a perforated space in the stomach (Think a care-bear with a old fashioned telephone mouthpiece in the center). Kids tend to hold onto it better, even try to eat it... (And MAN to they drool...) O2 comes through the holes. Pretty sweet.
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