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Intubating.

We're not using iGels, we're using VL to intubate everyone. Plastic sheeting is used. No nebs. No CPAP. Minimizing aerosol-generating procedures.

We've added IM Epi and Terbutaline to the standing orders.
 
Were intubating with VL, no nebs or bipap (bipap is rare for us). Of course 5 minutes after they made that decision I had a flight with a 7 month old on home bipap.

No way am I intubating a terminally ill 7 month old when i dont have to. I took him on bipap.
 
GMCmedic said:
Were intubating with VL, no nebs or bipap (bipap is rare for us). Of course 5 minutes after they made that decision I had a flight with a 7 month old on home bipap.

No way am I intubating a terminally ill 7 month old when i dont have to. I took him on bipap.
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I had a COPDer that was tight. She got a neb while she was sitting on the porch, then she got some solu-medrol and mag. The doc yelled at me for giving her a neb. šŸ¤·ā€ā™‚ļø
 
DragonClaw said:
Neb of ipatropium?

What's mag?
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Albuterol and Ipratropium. (a duoneb) and mag is magnesium sulfate, a smooth muscle relaxant. Works as a bronchodilator. I've taken this woman before and nebs, steroids and mag usually keep her from getting intubated.

We're carrying an Albuterol MDI with a spacer, but she needed the duoneb.
 
IV piggy pack mag is probably my favorite treatment for diff breathers who are tight.
 
NomadicMedic said:
Albuterol and Ipratropium. (a duoneb) and mag is magnesium sulfate, a smooth muscle relaxant. Works as a bronchodilator. I've taken this woman before and nebs, steroids and mag usually keep her from getting intubated.

We're carrying an Albuterol MDI with a spacer, but she needed the duoneb.
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Ah yes, duo neb. Duh šŸ˜„

What's a spacer on an MDI
NomadicMedic said:
It's a favorite of mine too. We use it a lot.
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Tight?
 
DragonClaw said:
What's a spacer on an MDI
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MDIAdult_cropped.jpg


That's a Metered Dose Inhaler with a spacer. The MDI and spacer are generally kept separated until needed.
 
DesertMedic66 said:
A lot of agencies have been switching to this process. Some are not intubating and others are not doing CPAP/BPAP while others are not doing either.

My flight service is still doing everything which is what I prefer.
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Honestly the use of a HEPA filter is more important anyway. A good seal of NIPPV + filter should fine.
 
silver said:
Honestly the use of a HEPA filter is more important anyway. A good seal of NIPPV + filter should fine.
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As long as the system is basically a closed loop between filters, yes. Any system that doesn't have the ability to filter exhaled air is going to generate aerosols. You have to know where the exhaled air is being dumped.
 
Today a covid pt coded somewhere. They were bagged. FD brought them in and the bvm was covered with rags. Not how effective that is for a seal ...
 
CALEMT said:
Yeah. Iā€™d be concerned if a fire department was incubating people.
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Iā€™m usually concerned with them doing eitheršŸ˜. Sorry man, had to. It was low hanging fruit.

In all seriousness, the S.A.L.A.D technique and I have certain become more fond of one another.
 
VentMonkey said:
Iā€™m usually concerned with them doing either
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At least I havenā€™t done any liver biopsies with a 3.25ā€ 14G ARS needle.

Low hanging fruit indeed.
 
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