Simple tricks

[omak42]

It went wrong for everyone in my EMT class at some point. Gloves and tape stick together really well, and my method doesn't involve touching the sticky side with a gloved hand.

We could keep doing this I guess. Let's just agree to disagree.

If you want to get technical....the wrapping tape method is a bad idea. Physically when going from one side to the other with the tape you have a high risk of turning the patients head. You SHOULD be taught to rip a strip off and apply it to the forhead first, then secure both sides under the board at the same time. This is the only way I would want to have it done to me, so its the only way I will ever do it with a patient. I really dont see how wrapping tape around the board and patient is going to save you much time at all. You should be able to rip a piece off apply it to the forhead, rip another peace off and apply it to the chin in a decent amount of time. If not then perhaps you should work on getting faster at it, instead of trying to find a shortcut.

 

[omak42]

A company can't provide patient care if the company can't pay the bills. As much as the bottom line might suck at times, it is something that has to be taken into consideration.

Oh I know this, and by no means am I saying that they shouldnt worry about bills. Its just based on the way he worded the statement, I took it to mean that the "evils that be" would turn it down in order to keep more money instead of using it to comfort the patient. I merely meant that instead of worrying about making as much money as the company can, then should worry about making the money they need and do what they can to make the patient more comfortable. If they arent willing to spend a little bit more money (if they can afford it) in order to make things better for the patient, then I dont think I would want to be working for an agency like that. We are in this field to put the patients priorities right behind our safety...not how much money we can make.

 

[Grady_emt]

If you want to get technical....the wrapping tape method is a bad idea. Physically when going from one side to the other with the tape you have a high risk of turning the patients head. You SHOULD be taught to rip a strip off and apply it to the forhead first, then secure both sides under the board at the same time. This is the only way I would want to have it done to me, so its the only way I will ever do it with a patient. I really dont see how wrapping tape around the board and patient is going to save you much time at all. You should be able to rip a piece off apply it to the forhead, rip another peace off and apply it to the chin in a decent amount of time. If not then perhaps you should work on getting faster at it, instead of trying to find a shortcut.

Why do you have to worry about the pt head turning if you are still properly holding C-Spine until the head is secured???

 

[Ridryder911]

I have to admit some of those items are nice, but alike anything else things cost $$. Maybe the emphasis would be using common sense. We use the disposable head immobilizer that has duct tape type immobilizer. Common sense is to remove your gloves when applying the tape.

The padded LSB is a nice concept, but not practical on most patients. In fact, I am surprised they are still available at that costs. Instead of LSB so many we researched and presented C-spine clearing techniques for field thus eliminating the use of LSB/C-collar on many (we still LSB about 10 -15 a day) as well as ER physicians are now quite aware a patient should not be on a LSB for > 30 minutes. They actually are usually removed from LSB almost immediately upon arrival (unless they specifically c/o C-spine or have neuro symptoms).

Personally, I have never seen success with "wrapping" nor would I suggest such. More asking why? As well, I NEVER secure the chin, rather across the rigid cervical collar. Head injury patients tend to have associated N & V and attempting to remove chin strap on a vomiting patient is difficult and increases risks of aspiration.

Most EMT's are ignorant on true application of immobilization. Padding using blankets, especially on bony prominences and joint areas. Many do not pad between straps which allows the straps to be tight and secure the patient even more so.

I suggest reviewing JEMS articles for more suggestions of "tricks of the trade".


R/r 911

 

[Outbac1]

Speaking of tape. Does anyone put tape on their leg to write on? I often have a roll of white 2" tape, (3M Durapore), stuck to the dash, (left of the air bag), to write notes on. I sometimes will put a 6" - 10" strip on my thigh to use as an instant note pad. On some calls it is totally filled with pt. notes and others it doesn't have a mark on it. Just depends how the call goes.

 

[skyemt]

I have to admit some of those items are nice, but alike anything else things cost $$. Maybe the emphasis would be using common sense. We use the disposable head immobilizer that has duct tape type immobilizer. Common sense is to remove your gloves when applying the tape.

The padded LSB is a nice concept, but not practical on most patients. In fact, I am surprised they are still available at that costs. Instead of LSB so many we researched and presented C-spine clearing techniques for field thus eliminating the use of LSB/C-collar on many (we still LSB about 10 -15 a day) as well as ER physicians are now quite aware a patient should not be on a LSB for > 30 minutes. They actually are usually removed from LSB almost immediately upon arrival (unless they specifically c/o C-spine or have neuro symptoms).

Personally, I have never seen success with "wrapping" nor would I suggest such. More asking why? As well, I NEVER secure the chin, rather across the rigid cervical collar. Head injury patients tend to have associated N & V and attempting to remove chin strap on a vomiting patient is difficult and increases risks of aspiration.

Most EMT's are ignorant on true application of immobilization. Padding using blankets, especially on bony prominences and joint areas. Many do not pad between straps which allows the straps to be tight and secure the patient even more so.

I suggest reviewing JEMS articles for more suggestions of "tricks of the trade".


R/r 911

Rid, we have many geriatric patients, and as of yet we don't have a protocol that lets us "clear" many pts in the field (one is coming in a few months, but it still won't really clear those over 70)...

our transport times are about 20 min... don't you think the LSB padding (or raft) would be beneficial for our older patients?

if i am off target, please let me know...

it pains us to have to board those over 70, but sometimes we just don't have a choice...

 

[Jolt]

Just to clarify... I don't tape the chin itself; I tape the chin part of the c-collar. You also have very little chance of torquing the neck if you unroll the piece of tape first and bring it down to stick it.

Alright, I think I'm done defending this.

 

[firetender]

All I know is I laughed at how the thread entitled "Simple Tricks" demented into "Simple Tricks Don't Work!"

 

[Doctor B]

Speaking of tape. Does anyone put tape on their leg to write on? I often have a roll of white 2" tape, (3M Durapore), stuck to the dash, (left of the air bag), to write notes on. I sometimes will put a 6" - 10" strip on my thigh to use as an instant note pad. On some calls it is totally filled with pt. notes and others it doesn't have a mark on it. Just depends how the call goes.

+1 I do the same thing on my complex flights or inter-facility transports. Another good location is on the opposite forearm of your writing hand so if you're taking notes while standing you don't have to bend over to write on your thigh.

 

[Gbro]

Jolt,
I agree with your tip, as I have done this many times. That strip of tape is usles in many situations. Even when i do use the strip i will a lot of times use a full wrap over it.
Its a practice thing. if you use good stabilization and alignment. This can be done successfully.

 

[OnceAnEagle]

I was a fan on writing on my forearm, as some have mentioned, until a warm day and CPR lead to me having a black streak across my forehead from wiping the sweat away.

Now, the back of the glove works wonders assuming it's not particularly messy to that point.

 

[Airwaygoddess]

2 inch cloth tape on top of your thigh, works pretty well for the basic info! ^_^

 

[emtwacker710]

...Also, on a less technical level, a bloody towel stays at the ER and is cleaned by the hospital laundry, the bloody BP cuff has to come back to the station in a biohazard bag and is cleaned by me.

I agree with this also, I would much rather leave any biohazardous materials at the hospital instead of bringing them back with me to my squad building.

 

[emtwacker710]

2 inch cloth tape on top of your thigh, works pretty well for the basic info! ^_^

yes it does, I also carry one of those small pocket sized notebooks so i can grab basic info on scene from family members if it's a bad call and dont have time to start the PCR