Sometimes you get patients who ask if you're studying to be a nurse or doctor.
No, actually, I'm a double major in International Relations and Geography.
They usually ask how you got in to this.
My friends made me do it. Peer pressure and all.
But sometimes you get patients who spend the next three hours discussing the economic sustainability of the European Union with you. :)
Sunday, May 30, 2010
Thursday, May 27, 2010
Nebulizers and Albuterol
NYC REMSCO BLS Protocols state that Albuterol via Nebulizer is indicated in patients over 1 year of age presenting with exacerbation of asthma/wheezing. Albuterol is the only medicine EMT-B's in NYC can give via Nebulizer. Refer to the 2010 protocols if you want more details.
This is how you do it, for those of you who didn't learn in tech school.
1. Gather the necessary equipment.
2. Assemble the nebulizer kit.
3. Instill the premixed drug (such as Albuterol or other approved drug) into the reservoir well ofthe nebulizer.
4. Connect the nebulizer device to oxygen at 4 - 6 liters per minute or adequate flow to produce asteady, visible mist.
5. Instruct the patient to inhale normally through the mouthpiece of the nebulizer. The patientneeds to have a good lip seal around the mouthpiece.
6. The treatment should last until the solution is depleted. Tapping the reservoir well near theend of the treatment will assist in utilizing all of the solution.
7. Monitor the patient for medication effects. This should include the patient’s assessment of his/her response to the treatment and reassessment of vital signs, ECG, and breath sounds.
8. Assess and document peak flows before and after nebulizer treatments.
9. Document the treatment, dose, and route on/with the patient care report (PCR).
(Randolph County, NC, EMS System Standards Procedure - Because really, I couldn't have said it better myself.)
Here are some video links if you're a visual learner like me. The narrator is using an actual Nebulizer machine rather than an O2 tank, but it's the same concept. It's a series if you want to see every last detail (and how to use Nebulizer masks), but these are the parts relevant to what I carry on my ambulance.
How to Get Nebulizer Ready for Use
How to Load Medicine in Nebulizer
How to Use Nebulizer Wand With a Child
This is how you do it, for those of you who didn't learn in tech school.
1. Gather the necessary equipment.
2. Assemble the nebulizer kit.
3. Instill the premixed drug (such as Albuterol or other approved drug) into the reservoir well ofthe nebulizer.
4. Connect the nebulizer device to oxygen at 4 - 6 liters per minute or adequate flow to produce asteady, visible mist.
5. Instruct the patient to inhale normally through the mouthpiece of the nebulizer. The patientneeds to have a good lip seal around the mouthpiece.
6. The treatment should last until the solution is depleted. Tapping the reservoir well near theend of the treatment will assist in utilizing all of the solution.
7. Monitor the patient for medication effects. This should include the patient’s assessment of his/her response to the treatment and reassessment of vital signs, ECG, and breath sounds.
8. Assess and document peak flows before and after nebulizer treatments.
9. Document the treatment, dose, and route on/with the patient care report (PCR).
(Randolph County, NC, EMS System Standards Procedure - Because really, I couldn't have said it better myself.)
Here are some video links if you're a visual learner like me. The narrator is using an actual Nebulizer machine rather than an O2 tank, but it's the same concept. It's a series if you want to see every last detail (and how to use Nebulizer masks), but these are the parts relevant to what I carry on my ambulance.
How to Get Nebulizer Ready for Use
How to Load Medicine in Nebulizer
How to Use Nebulizer Wand With a Child
Babysitting
I had a partner practically fresh out of tech school today, so we did the following:
NOT feeding the driver. >:(
1 highway flagdown a la 1 off-duty cop on motorcycle + 1 minivan driver about to miss their exit = 1 off-duty cop not on their motorcycle.
1 3-flight stairchair, with lift assist.
Attempting to feed the driver. Attempt FAIL.
Driver now caffeinated.
1 long distance interstate transport.
No food while driving 65 mph. :(
1 emergency call for respiratory distress.
15 mins waiting for NH elevator. >:(
Getting 1 hr of OT a la extended triage.
Driver so hungry they are no longer hungry.
DONE.
NOT feeding the driver. >:(
1 highway flagdown a la 1 off-duty cop on motorcycle + 1 minivan driver about to miss their exit = 1 off-duty cop not on their motorcycle.
1 3-flight stairchair, with lift assist.
Attempting to feed the driver. Attempt FAIL.
Driver now caffeinated.
1 long distance interstate transport.
No food while driving 65 mph. :(
1 emergency call for respiratory distress.
15 mins waiting for NH elevator. >:(
Getting 1 hr of OT a la extended triage.
Driver so hungry they are no longer hungry.
DONE.
Tuesday, May 25, 2010
Sunday, May 23, 2010
Security, I like you. I really do. But when I tell you that I can transfer a psych patient without an escort, it means that I can transfer a psych patient without an escort. It means, I've read the medical history. I've read the summary of events leading to the present hospitalization. And I'm telling you that this kid is going through a rough patch, but they're a kid. In fact, they're a downright sweet kid who got dealt a really tough family situation and a little bit of bad genetics.
So please, security, do not start telling me that I need an escort because kids like this might burst out. Do not tell me that all they know is violence.
Do not start telling me that in front of my patient.
Because you have never been on the other side of that. You have no idea how bad he's already hurting.
How do you think I got out of the hellhole I was born in?
There was a psych ER involved.
And do you really want to know what that kid told the doctors?
"I just want to help people."
So please, security, do not start telling me that I need an escort because kids like this might burst out. Do not tell me that all they know is violence.
Do not start telling me that in front of my patient.
Because you have never been on the other side of that. You have no idea how bad he's already hurting.
How do you think I got out of the hellhole I was born in?
There was a psych ER involved.
And do you really want to know what that kid told the doctors?
"I just want to help people."
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