Injectable Oxygen

[TransportJockey]

Maybe it was just my teacher's philosophy, but I was told if you have to push more than 2 IV drugs to fix the problem, then it isn't your job to fix.

Yay no pushing cardio toxic drugs during a code! I mean epi and vasopressin and amio and maybe dope or levo... Let's not do that anymore k? Your instructor is a genius!!! /sarcasm.

 

[EMT B]

possibly he was only reffering to the AEMT level...and he did actually wear a tshirt that said Keep Calm and BLS before ALS on the first day of class.

It was in WV

 

[Carlos Danger]

By that rule of thumb, If I am only doing RSI with 2 drugs, I guess I might as well administer one of them to myself.... Probably midazolam, that way I wont remember how awful of a clinician I am thanks to its amnesia effects.

Why does giving "only" 2 meds for RSI make you an awful clinician?

What do you need aside from an induction agent and an NMB?

 

[TransportJockey]

Why does giving "only" 2 meds for RSI make you an awful clinician?

What do you need aside from an induction agent and an NMB?

Analgesia? I've always been taught RSI is a vastly painful procedure and that you should give your paralytic, sedation and analgesia.

 

[STXmedic]

Analgesia? I've always been taught RSI is a vastly painful procedure and that you should give your paralytic, sedation and analgesia.

Devils advocate: NMB+Ketamine?

That, however, doesn't take into account that not every patient should get Ketamine.

 

[NomadicMedic]

Why does giving "only" 2 meds for RSI make you an awful clinician?

What do you need aside from an induction agent and an NMB?

Continued sedation? Anyone?

 

[TransportJockey]

Devils advocate: NMB+Ketamine?

That, however, doesn't take into account that not every patient should get Ketamine.

I'm still learning about ketamine. It's not something we ever see used out here so I tend to forget it. ops lol thanks.

 

[mycrofft]

The volume of O2 would have to be very small to be inject-able, I would imagine the injection would have to occur within the tissue of concern to do any good, and then the efficacy would only be for a very short period of time,
unless the dispensing device was large, and then you would still need to transport the stuff through the body?
I dunno, above my pay grade.

Again:

http://www.childrensinnovations.org/SearchDetails.aspx?id=1550

Article says the challenge being met was supplying oxygen to the heart without circulation (e.g., mechanically pulseless).
So, how does this bolus of oxygen get to the heart, the Pulp Fiction Giant Needle? And how does it perfuse to the entire myocardium? If this article is correct and complete, this is another embryonic "good idea" seeking advertising to attract development money, BESIDES DoD. At this stage, looks like BS for life support.

 

[Carlos Danger]

Analgesia? I've always been taught RSI is a vastly painful procedure and that you should give your paralytic, sedation and analgesia.

Done properly (gently and methodically), intubation should not be a very painful procedure. Uncomfortable? Yeah, probably very much so. But painful? Probably not.

The other thing to think of: does a deeply sedated patient experience pain?

Continued sedation? Anyone?

Sure. Use the same sedative that you used to induce (ketamine, propofol, midazolam, high-dose opioids, dexmedetomidine, etc.) and you still only need 2 drugs.

 

[Carlos Danger]

again:

http://www.childrensinnovations.org/searchdetails.aspx?id=1550

article says the challenge being met was supplying oxygen to the heart without circulation (e.g., mechanically pulseless).
so, how does this bolus of oxygen get to the heart, the pulp fiction giant needle? And how does it perfuse to the entire myocardium? If this article is correct and complete, this is another embryonic "good idea" seeking advertising to attract development money, besides dod. At this stage, looks like bs for life support.

CPR?

I would consider the potential uses of something like this for scenarios other than cardiac arrest.

Personally, I think we focus way too much on bringing people back from the dead.

 

[TransportJockey]

Done properly (gently and methodically), intubation should not be a very painful procedure. Uncomfortable? Yeah, probably very much so. But painful? Probably not.

I guess that makes sense too. I was thinking about it as I had been taught and it made sense to me. But you raise a good point as well.

 

[mycrofft]

CPR? Article states without circulation.

" The ability to keep blood oxygenated for even a short period of time under cardiac arrest circumstances or other circumstances in which a patient is unable to breathe or has no blood flow can prevent the tissue damage, including brain damage, that results from lack of oxygen."

Like you, I'd think CPR. And maybe shoot into the carotids.

I would consider the potential uses of something like this for scenarios other than cardiac arrest. Suggestions? Maybe gangrene? I can't think of one, not enough caffeine anymore nowadays...

Personally, I think we focus way too much on bringing people back from the dead.
Yeah, American medicine seems to be rescue rather than preventative oriented. The only advantage I see in going for the extreme cases is if they stretch the envelope for treatment of slightly less dead cases towards saves.

Part of the social contract which allows medical people to do outrageous things to others in an effort to save them, is that we try to save them. Otherwise, what we do would land us in prison or a mental institute.