IO vs External Jugular IV in trauma patients

[P_Instructor]

Yes, but you must remember the Subclavian was taught in the Paramedic text books for many years and central lines are still in some ground ALS protocols and not just for Flight or Specialty. Subclavian lines were no different than chest tubes, intracardiac epi and pericardiocentesis which were all part of the regular Paramedic curriculum not that long ago. Just 20 years ago we didn't have a helicopter and a trauma center on every corner.

Thanks. It was meant for a snicker or two, but I am apparantly like you.....an old time Medic (20+ years) who had the old curriculum and was taught these skills. I just wanted to see how 'wide-eyed' the newer Medics would respond.

[VentMedic]

I just wanted to see how 'wide-eyed' the newer Medics would respond.

The younger ones seem to be having a difficult time mastering peripheral IVs. Imagine if they had started in EMS several years ago when we had to maintain competency in all of the skills I listed and were even expected to be proficient at Endotracheal Intubation?

[P_Instructor]

The younger ones seem to be having a difficult time mastering peripheral IVs. Imagine if they had started in EMS several years ago when we had to maintain competency in all of the skills I listed and were even expected to be proficient at Endotracheal Intubation?

I agree. Knowledge is great, but you need the competency/skill mastery along with the knowledge base to be a good Medic. They go hand in hand. I think that institutions that provide the National Registry Skill Evaluation need to step up their game. I hammer my students (and also get headaches from banging my head against the wall) every day on skill mastery. They get to the skill stations and breeze right thru them, then come back to me and say they were too easy (wow, get that from a student!). If they are not competent in the clinical setting, keep on them until they can do it in their sleep, then scenario them to the brink of extinction using knowledge and skills to be a good Paramedic.

[crotchitymedic1986]

In male patients the superficial dorsal vein of the penis is a better option, as it is always accessible, and has less contradictions or should i say contradicktions ? Of course it means you have to touch a penis so that means the patient will die due to your homophobia.

As far as skills slipping, youve heard me say it a million times, but the decline in those skills is directly attributal to ACLS becoming a "noone fails class". I remember having to strategically place trash cans around the room for people to puke in because they were so nervous about failing back in the old days. The last 4 times I took ACLS, I didnt even crack open the book and never scored less than a 98 -- that is so sad. Create a new class for the doctors who cant pass ACLS, but return Paramedic ACLS class to the old days, and you might actually have Paramedics who can start IVs and intubate.

[chbare]

Sorry bro; however, if we are talking life and death, I can easily obtain access with the current IO technology in a matter of seconds.

Additionally, ACLS is not a skills class. ACLS is nothing more than a review of ECC guidelines. You learn skills in school and keep current through continuing education and an employer con/ed program. Maintenance of skills such as vascular access has no real place in ACLS. Why do people still think ACLS courses should be responsible for teaching people cardiology and skills. Even the two or three day horror classes taught nothing but intimidation. Sure, they were difficult and full of machismo.

If you want some challenge, you can always look at ACLS-EP where you will discuss more advanced clinical topics such as electrolyte abnormalities.

Take care,

chbare.

[tniuqs]

'DwayneEMTP'

In fact...if I remember right, a large part of my thinking on this was taught to me by some big hairy friggin' dude in Afg...his name escapes me...

Thanks for your response ol' man...

Dwayne

+ 5 on the dustdevil scale there Dwayne

Edited September 21, 2009 by tniuqs

[mobey]

Sorry bro; however, if we are talking life and death, I can easily obtain access with the current IO technology in a matter of seconds.

Additionally, ACLS is not a skills class. ACLS is nothing more than a review of ECC guidelines. You learn skills in school and keep current through continuing education and an employer con/ed program. Maintenance of skills such as vascular access has no real place in ACLS. Why do people still think ACLS courses should be responsible for teaching people cardiology and skills. Even the two or three day horror classes taught nothing but intimidation. Sure, they were difficult and full of machismo.

If you want some challenge, you can always look at ACLS-EP where you will discuss more advanced clinical topics such as electrolyte abnormalities.

Take care,

chbare.

I 100% agree with this statement.

I am taking my ACLS right NOW, and really...... it is just a review of my cardiology semester that will award me a frickin card. Pretty pointless if you ask me.

My cardiology class however.... phew...... THAT is where people are worried about failing.

So maybe this is progression eh? Taking a 3day course and making it a semester??

[tniuqs]

I 100% agree with this statement.

I am taking my ACLS right NOW, and really...... it is just a review of my cardiology semester that will award me a frickin card. Pretty pointless if you ask me.

My cardiology class however.... phew...... THAT is where people are worried about failing.

So maybe this is progression eh? Taking a 3day course and making it a semester??

And after you get your 5 0 number you will also have to enter all the areas covered (about 25 areas of competency)for the ACLS alone. You got to love ACoP and their Con Ed splendor it takes more time to enter in CIMS than it takes to do the entire alphabet course.

sheesh

[stcommodore]

Did someone honestly say its a good idea to canulate a patient's penis?! I can't imagien trying to document or tell the hospital that I put a 16g in the patient's ....um yea in his dick. Do you have to use bulky dressing to secure the shaft?! Dear god.

[P_Instructor]

Did someone honestly say its a good idea to canulate a patient's penis?! I can't imagien trying to document or tell the hospital that I put a 16g in the patient's ....um yea in his dick. Do you have to use bulky dressing to secure the shaft?! Dear god.

Hey, I can honestly state I've started a Boob vein with an 18 short. Circumstances beyond my control led to this, but it worked perfectly, even when the patient coded. We brought the patient back through it.........what works, works I guess......