Administration and Leadership, Airway & Respiratory, Patient Care

Letters

Issue 4 and Volume 34.

More Bubble Tricks
I just read your trick in the current issue of„JEMS (“Bubbles,” February). I, too, am surprised that this isn_t taught more often.

I_m a flight paramedic and utilize Mini-Med pumps often. I also have a foolproof way to keep all bubbles out of the picture when dealing with pumps. After I spike a bag, I place it upside down on a table, my leg or whatever_s handy and force prime the tubing by pushing down on the bag, thereby pushing the fluid„up into the drip chamber. This forces all the air out of the setup, and I never get an “air in line” error.

I look forward to reading the Tricks of the Trade column every month. Keep up the good work!

Jared Bogard, NREMT-P
Garden City, Kansas

Although I agree that air bubbles in an IV line„can be risky, and that all measures should be taken to avoid them, Thom Dick_s trick to keep them from entering the line wouldn_t work on many IV tubing designs that have the flow-control clamp below a “Y site.” This configuration prevents the clamp from being raised to the drip chamber. A better trick might be to use a forceps clamp to crimp the tubing just below the drip chamber in the same manner you suggest.„

Paul G. Bond, RN, CEN, MSN, ALNC
Palm Coast, Florida

Cheer-Leading
As a strong supporter of EMS 12-lead (and even 15-lead) ECGs, I find Keith Wesley_s view valid (“EMS 12-Leads After ROSC,” JEMS.com).„In any other circumstance, such as with patients experiencing cardiac-related chest pain, syncope, altered LOC, etc., prehospital ECGs can definitely play a key role in the paramedic_s differential diagnosis and treatment of the patient. In PNB (pulseless, not breathing) situations with ROSC, however, oftentimes the one or two paramedics on the ambulance are busy enough maintaining IV and anti-arrhythmic therapies, obtaining a BP and maintaining a stable airway … there simply isn_t enough time to obtain a 12-lead (or enough people).„If the transport time to the emergency department is long enough (as in rural/suburban communities), then I could see its use. But with a 5Ï10 minute transport time in larger communities, the benefit is in getting the patient to the hospital.„
MedicTN
JEMS