1. Medic Assist

2. Often when we are called to respond to treat a patient, we arrive to find a patient that has a life threatening injury or illness. Once Medic arrives we may be asked to assist them in the ongoing treatment of that patient.

3. Medic Assist Many of our protocols indicate procedures we are expected to help Medic carryout. In this lesson we will address some of these procedures and their protocol.

4. Medic Assist Our protocols and contract indicate additional performance measures and skills that are outlined by local medical control. These duties are to assist Medic personnel and to expedite patient care activities. As a EMT you should know your local protocols.

5. Medic Assist Located on the K:\\ EMS Division Protocols

6. Medic Assist We will also look at some equipment that Medic will be using and how we can assist them.

7. Medic Assist 1. Apply pulse oximeter and cardiac monitor. 2. Prepare IV set-up if advised. What do we assist Medic with? With any patient suffering from chest pain. Be ready to assist medic with the setup of 12 lead.

8. Medic Assist Anaphylactic Reaction 1. If a severe anaphylactic reaction is present (wheezing, respiratory distress, feeling of throat closing up, and hypotension), may assist patient in administration of personal anaphylaxis kit (Epi-Pen, Ana-Kit). 2. Apply pulse oximeter and cardiac monitor. 3. Prepare IV set-up and any medication if advised. What do we assist Medic with?

9. Medic Assist Respiratory Distress 1. If a severe asthma attack is present (wheezing, respiratory distress), may assist patient in administration of personal metered dose inhaler or nebulizer. 2. Apply pulse oximeter and cardiac monitor. 3. Prepare nebulizer set-up if advised. 4. Prepare IV set-up and any medication if advised. 5. If continuous positive airway pressure (CPAP) is to be attempted, prepare appropriate equipment. 6. If intubation is to be performed assist in tie down and check for tube location with stethoscope. What do we assist Medic with?

10. Medic Assist Medic Assist Burns 1. For burns > 25% body surface area or any inhalation, apply cardiac monitor and pulse oximetry. 2. Prepare IV set-up and any medication if advised. 3. If intubation is to be attempted, prepare appropriate equipment and assist in preparing end-tidal CO2 from monitoring device. What do we assist Medic with?

11. Medic Assist Chest Pain 1. If pain considered to be cardiac in origin per the patient, may assist patient in administration of personal dose of nitroglycerine. 2. Apply pulse oximeter and cardiac monitor. 3. Prepare IV set-up and any medication if advised. What do we assist Medic with?

12. Medic Assist Choking 1. Apply pulse oximeter and cardiac monitor. 2. Prepare IV set-up and any medication if advised. 3. If intubation is to be attempted, prepare appropriate equipment and assist in preparing end-tidal CO2 monitoring device. What do we assist Medic with?

13. Medic Assist Near Drowning 1. Apply pulse oximeter and cardiac monitor. 2. Prepare IV set-up and any medication if advised. 3. If continuous positive airway pressure (CPAP) is to be attempted, prepare appropriate equipment. 4. If intubation is to be attempted, prepare appropriate equipment and assist in preparing end-tidal CO2 monitoring device. What do we assist Medic with?

14. Medic Assist Procedure 1. All necessary supplies as described above should be readily available before attempting intravascular access. 2. Connect drip chamber tubing to extension tubing. 3. Remove tab from drip chamber insertion site on IV fluid bag.

15. Medic Assist 4. Insert, or spike, drip chamber into IV bag. Squeeze chamber and release so as to partially (50%) fillthe chamber with saline from the IV bag. 5. Open all clamps and remove the end cap on the IV tubing and flush IV fluid completely through thetubing. Replace the end cap when all air columns and bubbles have cleared the tubing.

16. Medic Assist 6. Assist in handling the angiocath and constricting band. 7. Cut tape into 4 or 5 lengths of 2-3 inches each. 8. If patient is an infant or child, prepare an arm board and bandages to make an arm board. Complications 1. Air embolus. #1 2. Infection.

17. Medic Assist Clinical Supplement 1. It is always important to use extreme sterile technique when connecting the tubing to the IV bag. 2. Always ensure that there is no air remaining in the IV tubing prior to fluid infusion.

18. Medic Assist Pulse Oximetry Measurement Indications 1. Breathing problems or other symptom suggesting a respiratory etiology. 2. Any patient complaining of breathing problems or chest discomfort, or any patient with a history of respiratory distress or breathing problems that prompted the 9-1-1 call and is refusing treatment or transport. Contraindications 1. None.

19. Medic Assist Pulse Oximetry Measurement Procedure 1. Prepare and assemble all equipment: a. Cardiac monitor with oximeter device and cable with attached detection device (finger probe) 2. Select finger and apply detection device by standard technique. 3. Ensure pulse correlation. 4. Obtain reading. 5. Apply supplemental oxygen as required per protocol. Side Effects 1. None

20. Medic Assist 12-Lead Electrocardiogram Electrode Placement Indications 1. Chest pain or other symptom suggesting a cardiac etiology. 2. Any patient complaining of chest pain or chest discomfort, or any patient with a history of chest pain or discomfort that prompted the 9-1-1 call and is refusing treatment or transport. Contraindications 1. None.

21. Medic Assist 12-Lead Electrocardiogram Electrode Placement Procedure 1. Prepare and assemble all equipment: a. 12-lead cable b. Electrodes (10) 2. Expose and prepare chest for electrode placement. This may require some limited shaving.

22. Medic Assist 12-Lead Electrocardiogram Electrode Placement 3. Apply electrodes as indicated: a. Limb Leads i. RA: Right upper extremity ii. LA: Left upper extremity iii. RL: Right lower extremity iv. LL: Left lower extremity

23. Medic Assist 12-Lead Electrocardiogram Electrode Placement Indications b Chest Leads i. V1: 4th intercostal space to right of sternum ii. V2: 4th intercostal space to left of sternum iii. V3: Between V2 and V4 iv. V4: 5th intercostal space at midclavicular line v. V5: 5th intercostal space at anterior axillary line vi. V6: 5th intercostal space at midaxillary line

24. Medic Assist

25. 12-Lead Electrocardiogram Electrode Placement 4. Instruct patient to be as motionless as possible and to refrain from talking. 5. The 12-lead electrocardiogram will be obtained by the paramedic by standard technique. Complications None

26. Medic Assist Medics monitor will! Assist you when bagging a patient. Assist you in speed of depth and speed of compressions. Monitors pulse oximetry and Co2 Interface our AED’s

27. New Medic Bag Late 2015 Medic introduced a new medical Bag for their equipment. Please formularize your self with it.

28. New Medic Bag

36. Medic Assist