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[audio:17_NeedToPee.mp3] (50:49) This week we talk about learning the 12 Cranial Nerves, in depth patient assessment, keeping fluids and drugs at the right temperature in the ambulance. Kelly tells you the secrets of peeing on long transports, both for the patient and the paramedic. Since Ron is learning IVs next week we talk about dealing with pediatric patients and needles, with Kelly the Pedi Stick King. Also what is a Critical Care Paramedic, does anyone really know? Apparently the Flight Medics do.
Kelly will be in Dallas this week at the EMS Expo starting on Wednesday and will be podcasting with EMS Educast, EMS Garage, and others as well as handing on EMS Newbie CDs.
On Thursday night, both Ron and Kelly will be on the Dr Anonymous show live on Blog Talk Radio.
Mentions:
Wenckebach Phenomenon, aka the Heart Block
Keys to Student Mastery of EMT Training
SEX, RELATIONSHIPS AND THE CARDIAC CONDUCTION SYSTEM
International Association of Flight Paramedics
University of Maryland Baltimore Department of Emergency Health Services
Having done a LOT of long distance transports in the past, I actually have a few extra tips for patients who need to pee…
If you have a clean up kit with those absorbent crystals, dump them into the bottom of the bedpan or urinal before the patient uses it. When they are done, give the stuff a few seconds to solidify, then no sloshing issue. If you don’t have the crystals, you can use ABD pads, chux, 4 x 4’s, etc. If recording output, this may not be advisable, but last time I checked, bedpans don’t have measuring lines. If, when you go digging for the urinal, you can’t find it, get creative. Suction cannisters, sterile water/saline bottles, heck, even the trash can with the red bag can work. Along those lines, if you do need to monitor output and the patient is female, dump the output into a suction cannister… the opening is a LOT bigger than the one on the urinal.
Question about the arterial lines… I know many monitors have the ability to monitor this nowadays, but is it common for a critical care EMT-P to establish one in the field? Or does the monitoring apply only if one has been previously inserted at the hospital?
On the injections, one of my old supervisors taught me that by smacking the site (or right next to the site) a few times before the stick, it kind of tricks the nerves in the area and it doesn’t hurt as badly… and it takes care of the tight muscle problems. Y’all ever heard of that? Your thoughts? Clearly, you don’t want to beat up the patient, but even just “flicking” the area helped in my experience.
Another excellent podcast! How about Lone Ranger/Tonto? Harry Potter/Ron Weasly? Garfield/Odie? Tubbs & Crockett? Shrek & Donkey?
Got a sidekick bit. Radioactive man and fallout boy (Bart Simpson’s comic book super heros)
Christine, we don’t start arterial lines in the field.
When we monitor a patient with one, we find the phlebostatic axis, zero the transducer and make sure everything is patent, and go with it. Gotta be careful about patient positioning in relation to the transducer, but that’s about all there is to it.
Thanks, AD!