Night Eight

Oh dude last night was so sweet.

I had my first test, which I felt really good about - so either I kicked some test arse, or I failed. I'll let you know.

I KNOW I rocked out on the bones and the body positions but I may have gotten Coccyx mixed up with Sacrum so I guess we'll see. And I know I did well on the blood pressure questions because I went with "Sys/Di" and...well, that's right so yay lol.

I had a few where I went "HUH!?" but mostly it was "Bam. Bam. Bam. Bam. REALLY? BamBambambam." I even had time to go get dinner and eat it before everyone else finished. O-o;

And then we did airways and it was thoroughly awesome.

Seriously.

Okay.

There are several awesome ways we can do this.

You do airways with the nose and/or mouth.

There are several different types.

Conscious
Nasal-Pharyngeal airway, a super comfy rubber tube that one shoves down the nose of the patient. This is not pleasant but can be used for a patient that may be having trouble with maintaining the airway. See that right there? Yeah that's the thing they shove in your nose. The beveled edge goes in against the septum (the thingy in the middle) and they just go "swoop!" down the nose.

I suspect it's highly uncomfortable.

I'm not going to test it and try it. It can also be used on unconscious patients.


The Nasal Cannula is something you've probably seen your gramma or some other random person in at some point. It's relatively non-invasive and low-flow which means you only give it about 1-6liters per minute (by comparison high flow is 15LPM). It's sort of... supplemental.

Generally the Cannula isn't used too much, especially not by an EMT-B. We're supposed to use "Non-Rebreather Masks" but sometimes they can give patients a very nasty feeling of claustrophobia so the Cannula gives oxygen without them feeling the need to panic.

This is applied by inserting the ends into the nostrils and hooking the edges of it over the ears before tightening the bottom piece somewhat like wearing earphones. Not too bad.

Non-Rebreather masks are sweet. They're for high-flow, 8-15LPM. Usually you should just go to 15. This is because it has a bag on it, which will fill with oxygen and the patient gets their air from that bag. Therefore no matter how fast the air is going, the patient is getting a nice regulated flow. This is applied by slipping the cord around the head and positioning the mask over the mouth and nose. It's only applied after you have put your thumb over the bag flap and held it for the bag to fill. Be sure to remove it before it pops. Because it will, if there's no way for the air to escape.


Unconscious
Oral-Pharyngeal Airway... please don't ever try to stick one of these in the mouth of a conscious patient. It will freak them the hell out. Also it looks like it hurts like hell. You put it in with the curve pressing down on the tongue until you meet pressure, and then you twist and push down, which then makes the curve follow your tongue and push it forward, keeping it from relaxing into the airway. Also? It keeps your panicked patient from biting your damn fingers off and choking to death on them. This happens more than I care to realize.

There are sizes for everyone. The Oral and Nasal Pharyngeal airways need to be checked before being crammed in or guess what? You find out what Patient X had for dinner. So, for the oral you measure from the corner of the mouth to the ear and for nasal from the corner of the nostril to the ear. These can be used in children and the iiiiiitty bitty ones are just too cute for words.

Combi-Tube airways are really cool. They involve taking a tube, cramming it down your throat, and then giving you oxygen through them. You don't want this, because I doubt it feels good. You do want this, because by the time the situation calls for this, you're likely to be quite hungry for some air. It isolates the Trachea, pushes air into the lungs and if you vomit has a neat little tube just for that, so you don't aspirate it. Aspirating that means you will choke on it. And guess what? Hydrochloric acid in your lungs means you may suddenly be down a lobe or two.

King Airway is basically the same as Combi-tube but has a lot mor give to it. It's also shorter, sitting above the Epiglottis. It's sized for people 4-5ft, 5-6ft, and 6+ft tall.

Neither of these airways can be used on children under 4ft tall, by the way.

That picture is of the King airway. The comments are mine.

I could picture the combitube but it's pretty much the same damn thing so I'm not going to bother.






Official favourite quote from the night:
"The more things I can stick in you, the more fun I have."

Guess how long you'll live without oxygen? As an adult, 6min. Yes. That's it. After 6min you start to go into respiratory failure.

So what did we learn?

We don't want to stop breathing, because not breathing means our heart stops. Also it means some crazy EMT is going to grab me by the jaw, yank my mouth open, and jam a long plastic tube down my throat before attaching a Bag-Valve and forcing oxygen into my lungs.

However, if this sounds like a fun night for you, I can see about renting some equipment and practicing on you. That'd be great! ^^

Fun Fact: Blowing oxygen into a baby's eyes will blind them. Stevie Wonder? Yeah, a nurse did that.

Also. Petroleum Jelly + Oxygen = Boom. No, they didn't let us test that. Dammit.