Intubation & BSI

[Sizz]

Hey all

When intubating a what type of BSI do you usually use other than the norm gloves?

Is it pretty much necessary for goggles or a face shield? Is it usually pretty messy or what do you use to determine this?

Were going to be on advanced airways shortly and no I do not want a face full of vomit but I'm not sure how messy these get or how close you have to get to the pt's face / airway while preforming this airway.

 

[jjesusfreak01]

Totally just talking out of my rear end here, but the primary use of advanced airways in EMS is for patients who cannot secure their own airway, meaning that theoretically they don't have a gag reflex and aren't going to be throwing up or spitting up stuff on you. That said, its always a possibility, and i'm sure it happens all the time. You should think of it more relation to a real call. If you are having to intubate someone, what are you doing on the call and what do you expect you will want to do/have time to do? On a cardiac arrest patient, I highly doubt at any point you are going to think about going into the truck to don a gown before intubating. However, if I knew I was going into a scene with a drunk syncopal patient, I would probably bring along a facemask, just for giggles.

You do have to get fairly close to a patient to intubate (i'd say your head will be within 2ft), and projectile vomit can travel far further than the maximum distance from which it is possible to intubate.

Also, what are you talking about anyways? You make it sound like you are going to be practicing advanced airways on your classmates after lunch at Burger King...

 

[abckidsmom]

mask and face shield, yep. Whenever I do any invasive airway management.

I worked in a surgical ICU for a while after nursing school and learned that lesson by getting slimed with bloody mucus flung through the air by a yankauer. Nasty!

So, I don't feel too stupid having on a mask when I turn on the suction, get out the ambu bag, or BLS airways.

 

[MediMike]

Totally just talking out of my rear end here, but the primary use of advanced airways in EMS is for patients who cannot secure their own airway, meaning that theoretically they don't have a gag reflex and aren't going to be throwing up or spitting up stuff on you. That said, its always a possibility, and i'm sure it happens all the time.

Not sure how many codes you've worked, but emesis is quite often present. Along with the possible damage to airway anatomy resulting in blood, and just other random goo you seem to find on these folks, I strongly recommend safety glasses.

You do have to get fairly close to a patient to intubate (i'd say your head will be within 2ft), and projectile vomit can travel far further than the maximum distance from which it is possible to intubate.

Also, what are you talking about anyways? You make it sound like you are going to be practicing advanced airways on your classmates after lunch at Burger King...

As for distance Sizz, it all depends on each patient's anatomy. What I CAN tell you though is pull your head back! When you try to stare straight down into their airway you screw yourself out of the proper anatomical axis you provided by putting them in the sniffing position. I've always found it helpful to lay down nice 'n flat on the floor, relax, and just take a little looksey haha

Jesus I'm gonna take a wild guess and assume he's referring to the fact that his class will be getting checked off on ETI in the classroom soon so as to be able to perform the skill in the field.

 

[MasterIntubator]

At a VERY minimum, we use:
- Gloves
- Goggles/eye protection
- Respiratory protection ( cardiac arrests tend to get this omitted )
- Suction, on and ready to go

And that is just for the BSI part.

 

[Sizz]

Not sure how many codes you've worked, but emesis is quite often present. Along with the possible damage to airway anatomy resulting in blood, and just other random goo you seem to find on these folks, I strongly recommend safety glasses.



As for distance Sizz, it all depends on each patient's anatomy. What I CAN tell you though is pull your head back! When you try to stare straight down into their airway you screw yourself out of the proper anatomical axis you provided by putting them in the sniffing position. I've always found it helpful to lay down nice 'n flat on the floor, relax, and just take a little looksey haha

Jesus I'm gonna take a wild guess and assume he's referring to the fact that his class will be getting checked off on ETI in the classroom soon so as to be able to perform the skill in the field.

Thank you MediMike

 

[jjesusfreak01]

Jesus I'm gonna take a wild guess and assume he's referring to the fact that his class will be getting checked off on ETI in the classroom soon so as to be able to perform the skill in the field.

Yeah, I was kidding about that. The way it was phrased just made it sound like a big mess.