the 100% directionless thread

StCEMT said:
Does anyone have a good reference guide for inflating pediatric ETT cuffs? We've recently switched to them. I know the bulb can be used as a test on tubes, but considering the infrequency in which we intubate a kid, I'd like to keep a cheat sheet with our broselow tapes.
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I’m not aware of any guideline for how much to inflate ped cuffs. There’s so much variation in tracheal size between kids of the same ages & weights that I don’t know how that would work.

Don’t your pediatric tubes have the max cuff volume printed on the pilot ballon? Or at least on the packaging? That’s a good starting point.

A manometer really is the best way. If you can’t get one of those added to your airway kit (they really should be used on adults, too), a leak test is a decent alternative. That can be challenging to do in the field though, so if you have short transport times, I personally (some would disagree with me) think it’s acceptable to use the “squeeze test”: inflate the cuff until the balloon starts to feels taught, but not firm.
 
We don't even use a manometer that often, it gets pretty tricky when you're trying to adjust the the cuff pressure on a 3.5 tube. You also can't use them on water cuff trachs

We typically just go until there isn't evidence of leak. You can certainly listen for it, or if you are using a vent look at your waveform, I vs E volumes, and pressures.
 
My wife left me a few subtle hints about Christmas gifts.

“Buy me that Littmann stethoscope with chocolate tubing and bronze bell and black oil Dansko shoes. And that’s it!”

Copy that.
 
NomadicMedic said:
My wife left me a few subtle hints about Christmas gifts.

“Buy me that Littmann stethoscope with chocolate tubing and bronze bell and black oil Dansko shoes. And that’s it!”

Copy that.
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Pfft, mine just texted me an itemized Amazon shopping list. “It’s ok babe, you don’t have to get all of it for me.”
 
Qulevrius said:
Pfft, mine just texted me an itemized Amazon shopping list. “It’s ok babe, you don’t have to get all of it for me.”
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You don’t have to.... but you really really should get all of it.
 
@Remi I haven't actually opened one to look and test it, these are a very recent change.

I don't know that I could get them added to our kit, but I do think I could make a pretty good case for them being on the supervisor truck. We do have short transport times though, so while I've played around with the bulbs, I am just trying to make sure whatever I put out is simple and effective.

@Peak we don't have vents on every truck. Now we might be able to get supervisors to take vents on all peds arrests (we just got T1's), but as of now it's just using a BVM. Now if that becomes our new standard, then that would be an option.
 
Lo2w said:
I'm torn between the stand mixer and drill.
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Just make sure you're not too close to this while you're between the stand mixer and drill...
Screen-Shot-2013-06-06-at-1.28.31-PM-625x352.jpg
 
Per the PA from ortho 1, my injury is "impressive" and he's not really sure how it's possible. I'll "Definitely" need surgery and that's why I'm being referred to a foot/ankle only surgeon. Because I guess it's that jacked up? But I'm walking again without a boot or crutches, per ortho 1. It might be long term issues that need surgery. Something about my talus not being connected to my tibia or something.

Workman's comp adjuster is delaying things on all fronts. Says she doesn't have the info why I need to see yet another specialist. So the new dr can't get approval for the consult.

As far as Christmas gifts go, my dad always requests super expensive things that I can never afford. But I got my good sister a knife with a seatbelt cutter and glass breaker and got a custom digital painting of a budgie of hers that passed away.

My mom has a list that I'm getting a book from. She reads a lot of books.

But I'm not sure when I'll see them next. I don't have to.

Ah, holidays.
 
CCCSD said:
No kidding. If Dragon Claw can get it, get a WC Attorney and have them protect you. They will be paid from the settlement.
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My buddy went out on work related injury and from not only him, but others who have gone out on injury I'm making it a personal mission to not get injured. It sounds like a serious pain in the *** just to get simple procedures like MRI's done on work comp.
 
I had an exposure and what was funny is that workers comp was the easy one. The billing department of the hospital was a pain in the *** as they refused to send the bill to wc. Wc said they had to receive it from the biller directly but said the second they get it they will pay it. Which they did.
 
CCCSD said:
No kidding. If Dragon Claw can get it, get a WC Attorney and have them protect you. They will be paid from the settlement.
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Settlement. Is being slow enough? I mean, it's been 2 weeks. What's reasonable for getting stuff done?

The dr told me they wanted to schedule me, but the lady wasn't returning her calls.

But the lady said she had a family emergency last week and the phone lines had issues. I guess if they truly had phone issues, nothing can BSE done, but if she had an emergency, shouldn't someone have covered her workload? How much work does she actually have? (Not that y'all would know that last bit)
 
Oh and another thing.

The MRI imaging center couldn't tell me the results immediately. They don't have a dr on staff (or someone "allowed" to) or something, that's reasonable for the imaging center. They sent a copy of the reports to the referring dr (Not the dr I'll go to for the surgery or the person who needs them), so I had them send them to the new dr, but they wouldn't even read what was on the report. At this point, they're not interpreting anything, just reading notes. They said they can't release me info to me without permission from a dr. (Which one, I don't know).

So this whole time, I'm wondering if I'm risking messing up my foot by walking on it (With a limp). They know, but they won't tell me.

I have a CD of the MRI, and I tried to look at it, but I can't tell. It's all just blobs. I can see the bones in it, but that's really it. I didn't think it would be this hard.
 
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