MplsMedic

When I was in class, we had to start IV's on eachother. We had to have at least 15 successful IV starts in the classroom, and 5 on the class ambulance. It was interesting to say the least. No one wanted to come to class after the first week. IM and SQ were practiced on dummies, because it isn't such a good idea to inject anything into your muscles or subcutaneous tissue unless it is necessary (i.e., saline is NOT a good idea- tried this one day). The new medic class just started and I went in on Thursday to show my support. I got stuck 4 times, and every single person dug around for awhile before they hit me. I actually had one guy digging for five minutes with an 18g on the radial side of my wrist (OW) for 5 minutes before I gave in and drew with pen on my arm where the vessel was. He got it then...

DON'T pull the tube. Yes, there might be a cuff leak or some other equipment malfunction, but I would take a look down with the laryngoscope to see exactly where my tube was. You can always reconfirm, or pull and reintubate. At least with the tube still in there, you have some sort of landmark (i.e. esophagus or trachea). This can be a sticky situation if your partner is "SURE" the tube is in the trachea (happened to me, tube was in the belly). Be sure to repeat all of your confirmatory steps if you ever think that the tube may have moved. What were lung sounds like? ALWAYS recheck when the pt is moved as well... Other than that, I don't know...