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Tricks of the trade!


FireResq617

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Just wanted to throw this question out and see what kind of responses I get.... Does anyone have any "tricks" they would like to share for all!

Good for cold weather.... throw a bag of NS or LR on the dash board for heated fluids...just make sure it does not get too hot!

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The IV bag on the dash, in theory, is a good one. HOWEVER, I have noticed that when I do that, the bag is still cold on the side closest to the glass. A co-worker had the idea of a heating pad that runs in cycles. He put it in the action area with 2-3 bags, slightly wrapped around it. It goes on for about 10 minutes and is off for about 15-20. He keeps the back relatively warm (comfortable), so that the it doesn't get very cold in the back.

A nurse showed me a "trick" for patients with difficult to find veins. I had always used a 2nd tourniquet with some success. He used a latex (if no allergy) glove just below the tourniquet. Helps put more pressure on the veins to promote the back-up we look for.

And for patients on steroids or blood thinners, instead of a tourniquet use hand pressure (preferably your partner so you have both hands available) or a BP cuff inflated just above the diastolic reading. If there is too much pressure, as with a tourniquet, it can cause the veins to blow before you can even thread the cath..

If you have the life pak 12 monitor, and use ETCO2, some of the new cannula's have a port for you to attach O2. There are 2 types. One allows you to use an unmodified supply tubing. The other type you have to cut one end of the tubing and insert it into the larger opening just below the junction. Wish I had a picture to demonstrate. Maybe tonight at work I will do that.

Have more, but I just got home and we were busy... me going beddie bye.

Shannon

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Well this is from another website where we had this stuff come up, so I'll just copy my response to that here:

I've never gotten comfortable writing on tape on my leg. I still use gloves. I had a new RN on a flight with me the other day looking at me like i was crazy for it. She'll catch on to all the strange things medics do here soon!

A few things I've learned:

-Keep your EKG electrodes attached to the leads, it'll save you one step

-If you have a patient who is leaking large amounts of bodily fluid onto the floor, keep your feet on the cot undercarriage and be sure to warn your partner to be careful opening the doors when you get to the ER. You don't want them to get hit with a tidal wave of nasty.

-A BP cuff makes a great tourniquet when you need to do an IV

-If the adapter keeps coming off your ET tube take it off and wipe it with an alcohol prep, it'll make the plastic a little bit tacky and keep it in place

-Always carry 3 or 4 pens with you, it is very embarrassing to have to steal the firefighters all the time. Pens always seem to disappear. Also keep a pen just for patients to use when they sign the forms.

-Always use the restroom whenever you have the chance. You never know when a call will come in.

-In the winter time keep a few bags of IV fluid on the dashboard over the defrost vents. It'll get them nice and warm for your patients. Heating pads work much better for this, but not everyone has that option.

-Emesis basins are never big enough, use a trash can instead. I don't know who designed those things, but they are pointless. Puke hits the curve and flies right at your face.

-Hydrogen Peroxide takes stains out of white uniform shirts, just apply with a 4x4 and your good to go for the rest of your shift

-Tap the cot frame against the back bumper to make sure its locked. I only forgot once thank god we were just arriving on scene.

-Always be extra nice to nurses and dispatchers, they can make your life a living hell. Bring food to them whenever you get the chance.

-Always look professional, it will instill confidence in your patients. Always bring an extra uniform to work, you never know when you're gonna need to change!

-Never run, its not you're emergency

-Keep around 10 pairs of gloves in your pocket. When you have multiple patients you'll be changing gloves alot! Also wear two pairs and only change the top one, stops the problem with sweaty hands.

-Scoop stretchers are COLD! If you have the time turn on the patient's shower and leave the scoop in the bathroom. The steam will warm it up a bit while you get a quick history.

-Never, ever, cut a down jacket. You'll only do that once!

-50 lbs=23 kgs, the easiest way for me to convert..

-Not quite sure how to explain this one, but if you can't hear the BP/lung sounds in the back of the box try biting down on your back teeth and putting your feet on the cot. It helps me out.

Well can you tell I was bored? I haven't had any calls for 8 hours.

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Cold Scoop Stretcher? Folded bath blankets on either side... provides comfort and warmth (and cuts down on the "pinching affect").

Hard time finding radial pulse? Use three fingers instead of two, vary the pressure of your fingers like you are playing a piano until you find it. Also, elderly people with osteoporosis or rheumatoid arthritis often times have bone deformities that actually shifts the location of the artery. I've found some pulses half-way up the forearm on an extremely deformed patient.

Nasal cannula for eye irrigation.

Towels for padding when using the KED, instead of the stupid unuseable padding that is provided.

ALWAYS have extra towels.

Nail polish stopping your SPO2? Turn the probe sideways, don't fool around with the remover... Oh, and if the pulse-ox isn't reading, try using the pinky. It's the least used finger and has far less capillary bed damage than the others.

IV tips. Put tourniquet close to where you are attempting the IV. So if you are going for the hand, put the turniquette on the forearm. Vein not popping up with normal means? Try a hot pack over the vein, causes vasodilation.

Navigating for your partner while responding to a scene? Call out the last 3-4 roads that come up BEFORE the road you want. Allows your partner to be more relaxed and visualize his path better.

Lock yourself out of your car? Steal a B/P cuff off the Amb, slide it between the glass and the rubber, pump it up, then use a coat hanger to get the latch. :) It's like using cricoid pressure for a tube, allows better visualization. :)

Hope there is at least somebody who doesn't already know these....

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