crotchitymedic1986 Posted December 31, 2008 Share Posted December 31, 2008 Modeled after the "take it or leave it game" post, I am suggesting a new game to challenge your knowledge or skills. I am posting this game under an EMT and Paramedic heading. Here is how it works: You challenge us by asking a hard EMS question; could be any EMT knowledge topic of your choosing. We are then challenged to answer it, WITHOUT CHEATING BY LOOKING AT THE INTERNET OR OUR OLD TEXTBOOKS. Once you answer the question, you then post a new hard question. Remember, you are on the honor system. Here is the first tough EMT question: You have just inserted a combitube in a patient and have ventilated the patient. Which balloon do you blow up first, and how many cc's of air does each balloon take ? Link to comment Share on other sites More sharing options...
Eydawn Posted December 31, 2008 Share Posted December 31, 2008 Combitube, specifically? Small syringe first, 15cc's if I remember correctly- large syringe next, 80-90 cc's (basically inflate it until you meet good resistance and pop the tube off the syringe.) Small syringe is distal balloon, large syringe is proximal balloon. But you listen after the small one- put the BVM on the white connector, ventilate and listen... if you hear breath sounds AND no abdominal gurgling, you're in the trachea so you leave the large syringe alone. If you hear gurgling and no breath sounds, use the large syringe and then confirm for breath sounds. Since we seem to be looking at more advanced type BLS, I'll continue the trend... List in step-by-step order how you would gain venous access on a patient needing D50 and the administration thereof. Don't miss anything... each tiny detail is important. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
itku2er Posted January 1, 2009 Share Posted January 1, 2009 Gather your supplies Tape angiocather at least a 20 guage alcohol preps gloves Amp of D50 (go ahead and open it before you start your IV) 2 by 2's tourniquet a hep lock cap 30 cc syringe of saline You may put on your gloves before you start any of the following. 1. Explain to the patient if they are alert what you are going to do. 2. Tear your tape off and put it where it will be handy and ready to use. One peice of tape you make smaller for the taping of the canula when you get it in. 3. Push a little saline into the hub of the hep lock cap. 4. Pick your site. 5.Apply a tourniquet high on the upper arm. It should be tight enough to visibly indent the skin without causing the patient any pain. 6.When you find a suitable vein either by site or palpation prep the skin with the alcholol pad. 7. Get your angiocather out and keep the bevel up. 8. Pull the skin tight around the vein you have picked out. This can be done in several ways I prefer to pull it toward the wrist. 9.Push the angiocath into the skin till you get flash back in the hub of the system. 10. After this slightly advance the cather into the vein 11.Release the tourniquet. 12. apply slight pressure above the vein. 13. Push the spring load button so the needle goes into the saftey port. 14. Place your hep lock cap onto the site. 15. Draw back to make sure you get blood into the syringe then flush it to make sure it flushes with out problems or the vein wont blow. 16. Tape it down. 17. Wipe the hep lock cap off with an alcholol prep. 18. Insert the needle into the hep lock and push the D50. 19. Recheck your Blood sugar level. I know probably forgot something but this is hard to type off the top of your head when you are jsut used to going and doing it. Good one Wendy. Explain the proper technique for applying an air splint to a broken tib fib. Link to comment Share on other sites More sharing options...
Kaisu Posted January 1, 2009 Share Posted January 1, 2009 oops - EMTs only... so sorry - my entry deleted Link to comment Share on other sites More sharing options...
itku2er Posted January 1, 2009 Share Posted January 1, 2009 oops - EMTs only... so sorry - my entry deleted its for anyone Kaisu i am an intermediate but I replied its good for anyone to participate. Link to comment Share on other sites More sharing options...
spenac Posted January 1, 2009 Share Posted January 1, 2009 its for anyone Kaisu i am an intermediate but I replied its good for anyone to participate. Nope some of you are not allowed. :twisted: Link to comment Share on other sites More sharing options...
Eydawn Posted January 1, 2009 Share Posted January 1, 2009 Crucial part of D50... draw back multiple times during the push to make sure you still have vein patency. Everything else you nailed, Terr! Kaisu, we don't discriminate... go ahead and play. And I have never used an air splint (changing altitudes make em kinda problematic) so I'll pass and let someone else do this one. Wendy CO EMT-B Link to comment Share on other sites More sharing options...
itku2er Posted January 1, 2009 Share Posted January 1, 2009 Lets change it to the step by step procedure for applying a KED! (it was brought to my attention that not everyone uses air splints and I am really enjoying this thread and don't want it to die, so I will be more careful on the things I choose. Like I said I had to really sit down and THINK about a procedure I just go and do everyday and its harder than it looks to get every little detail in like with the aspiration of the D50, Good learning points for all us if we just all participate.) Link to comment Share on other sites More sharing options...
Chief1C Posted January 1, 2009 Share Posted January 1, 2009 Carefully take the splint out of the package, cut it in half with a pair of heavy shears, ever so gently.. and throw it away. Use three board splints, and five cravats instead. Lets change it to the step by step procedure for applying a KED! Link to comment Share on other sites More sharing options...
spenac Posted January 1, 2009 Share Posted January 1, 2009 Crucial part of D50... draw back multiple times during the push to make sure you still have vein patency. Everything else you nailed, Terr! Kaisu, we don't discriminate... go ahead and play. And I have never used an air splint (changing altitudes make em kinda problematic) so I'll pass and let someone else do this one. Wendy CO EMT-B Now you can not play either. :twisted: Link to comment Share on other sites More sharing options...
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