Paramedic Survival Guide by Peter A. DiPrima

Author:Peter A. DiPrima
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2012-04-14T16:00:00+00:00

MANAGING THE INTUBATED PATIENT

End-tidal CO2 waveform capnography is truly a standard of care throughout the nation and is used to confirm and continually monitor intubated patients.2 A trick in limiting flexion and hyperextension of a patient’s neck and airway is to apply a cervical collar and immobile his or her head and spine to a long backboard after intubation. This process reduces movement on the obvious trauma patient and reduces movement in the intubated medical patient. This significantly reduces the possibility of the endotracheal tube from being dislodged during transport and patient movement.

Tips and Tricks

When a patient is placed on a backboard (long spine board), take a blood pressure cuff and place the bladder under his or her lower back. Inflate the cuff until the patient feels comfort in the lumbar region of the back.

While extricating a patient down a flight of stairs using a stair chair who has an IV line in place, use a hemostat or karabiner; run it through the hole in the top of the IV bag and clip it onto your shirt lapel. This will keep the IV bag out of the way and keep the IV line flowing.

When knocking on a door, make it a habit to stand to the side of the door. If you do it every time, you will instinctively do it on a call where it might save your life.

Tape a soft-tip suction catheter to the laryngoscope blade. The catheter hole to control suction is taped to where your thumb is when holding the handle. During intubation, you can suction at the exact time and location needed to visualize the cords. Caution: You are going to need to work on how to tape the tube to the blade. Practice on a manikin to ensure your suction catheter and tape don’t block your vision; it took me a few tries during practice before I figured it out. A key to success is to put the catheter tube to the outside of the blade. Put the tape flat so it doesn’t cover your vision down the inside of the blade.

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