AnthonyM83 Posted August 25, 2009 Posted August 25, 2009 I have a good list already, but want to get at the creative knowledge of other providers. For a 70 minute EMT skills airway lab, what would you cover in a hands-on lab meant to cover BVM, NPA, OPA, Suction, O2 Administration as it relates to the trauma patient. Students have already practiced these skills, but not in relation to a trauma patient. I want to make it applicable and bring over topics they've seen in lecture only so far. Current ideas: Scenario that involves hyperventilating patient. Patient throwing up, rolling to side while holding c-spine, suctioning, wiping secretions to regain good seal. Conciouss to unconscious. Breathing to not breathing. Gag to no gag reflex. Patients in awkward position and gaining in-line spinal stabilization. Looking for a lot of the little stuff. Trouble shooting perhaps that we learn from the field that I might forget. Stuff like wipe vomit off face after throwing up, instead of having the BVM slide around the face from slipperiness. 1-person bagging with jaw thrust (any good tips on this let me know). Coordinating strapping patient to board while bagging. Etc. Etc. It's tomorrow, so post now!
tskstorm Posted August 25, 2009 Posted August 25, 2009 I have a good list already, but want to get at the creative knowledge of other providers. For a 70 minute EMT skills airway lab, what would you cover in a hands-on lab meant to cover BVM, NPA, OPA, Suction, O2 Administration as it relates to the trauma patient. Students have already practiced these skills, but not in relation to a trauma patient. I want to make it applicable and bring over topics they've seen in lecture only so far. Current ideas: Scenario that involves hyperventilating patient. Patient throwing up, rolling to side while holding c-spine, suctioning, wiping secretions to regain good seal. Conciouss to unconscious. Breathing to not breathing. Gag to no gag reflex. Patients in awkward position and gaining in-line spinal stabilization. Looking for a lot of the little stuff. Trouble shooting perhaps that we learn from the field that I might forget. Stuff like wipe vomit off face after throwing up, instead of having the BVM slide around the face from slipperiness. 1-person bagging with jaw thrust (any good tips on this let me know). Coordinating strapping patient to board while bagging. Etc. Etc. It's tomorrow, so post now! Remind students that NPA is not inserted in patients with craniofacial trauma. Educate them about how to assist ALS when the PT is intubated. Please please please teach your students the proper way to put a NRB on the pt if they have a collar ... (most collars have hooks to attach the NRB to, if not the NRB goes on before the immobilization ...) How to BVM/open airway while pt is in sitting position awaiting extrication. That's all I cant hink of for now.
Chief1C Posted August 25, 2009 Posted August 25, 2009 Securing a patent airway, suctioning of copious amounts of blood, from collared pediatric, with 8" stick apparently impaled through the back of his oropharynx. Had this patient just after I became an EMT. Six year old male, running around the yard, tripped on a post that was driven to tie a dog to. He had a small stick in his right hand. Somehow, he fell onto it, and it went into his mouth, throat, and either through, or just cut the oropharnyx slightly. He was calm as could be, sitting there leaning forward, bleeding from the mouth. Managed to mumble, "if I sit like this, the blood just runs out". He had no labored breathing, good sats, no apparent swelling; on a nasal cannula at 3. The stick was in the corner of his mouth, and off to the side, of the back of the throat. I tried to be serious, but not scare him, about not touching it. He says, it'll come out. No. Bad idea. I had gotten OMC on the way, and asked if I should remove it; and he said only if there's a significant airway compromise. I wasn't in a hurry to remove it, since it didn't appear to affect his respiratory abilities. I had it partially secured, I cut the top off of an adult size guedel airway, put it over the stick, so he could close his mouth, but not bite the stick. Then put an 18FR suction cath in the mouth, and showed him how to control it w/ his thumb. Folded some heavy tape, sticky side out, and put it around the airway top, and went around his head, then taped that in place with silk tape. But, it wouldn't stick. He was collared, boarded, slightly tilted to the left, suctioning his mouth by himself. I reached for some soft tape, when the driver says, no don't do that. The kid pulled the stick out and says, it wasn't stuck. Didn't set off any worse bleeding, didn't swell up. So, I had to wonder if it was ever impaled, maybe just caused a cut? Dunno.. But it was the damnedest thing I ever saw. High on the pucker factor.
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