Tuesday, 12 August 2008


As a paramedic I have all the skills of an EMT and some. I'll split it up into Airway, Breathing, Circulation and Drugs, Here goes.
Airway mangement, as well as the basic oral and nasal airways we can insert a laryngeal mask airway (fanny on a stick, pardon the expression!) or an endotracheal tube which offers better airway security. Trainee paramedics need to go into the operating theatres to perform these under supervision of an anesthetist and get 'signed off ' by the consultant before being allowed to use them on the street. Cricothyroidotomy (Cric), 2 types, needle and the use of a SAD (surgical airway device). Most other trusts train their paramedics in the needle version. This is a procedure where we put either the needle or SAD through the wall of the windpipe in order to get oxygen into the lungs where all other methods have failed such as in the patient with a blocked airway or severe facial trauma. This is a last resort airway rarely needed. I have performed this and will tell the story at a later time.
Breathing, in severe chest trauma or rarely asthma I can decompress the chest by inserting a needle into the chest. This is to relieve the pressure that can build up in the chest cavity after a lung has collapsed. The condition is known as 'Tension Pnuemothorax' and is life threatening.
Circulation, Ican insert intravenous cannulae (I.Vs, drips), these vary in size and go into the veins - used for the admistration of drugs, fluids and for taking blood samples. If I can't get an IV in I have the option of being able to go IO (intraosseous access) which involes putting a needle into the centre of the bone using an IO drill. Again this is reserved for seriously ill patients both adult & children. Apparently it is no more painful than a standard IV! I wont be volunteering to see if it is or not! The painful bit is the drugs or fluids going in, we can administer local anesthetic to minimise the pain.

Oooops, gotta go, just got a job will carry on with this soon.

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