WHUt we gonNA dU IV Maintenance Bleeding and Shock Chs 22 & 23 Soft Tissue Injuries Ch 24 Chest Injuries Ch 27 Injuries to ABD and Genitalia Ch 28.

wHUt we gonNA dU

• IV Maintenance• Bleeding and Shock

Chs 22 & 23• Soft Tissue Injuries

Ch 24• Chest Injuries

Ch 27• Injuries to ABD and Genitalia

Ch 28

IV MAINTAINCE

• I Defined

To manage and troubleshoot a pre-established IV line

• II Three reasons for an IV line

Volume Replacement

Fluid Replacement

Medication Route

• III Common Sites

Lateral aspect of Upper Extremity

Anterior aspect of elbow

anticubital fossa

Back of hand

• IV Common Fluids

Crystalloid

a. Does not contain proteins or large molecules

b. Examples are D5W and NS

Colloid

a. Contains proteins or other large moleculesb. Examples are albumin

• IV The EMT-B can transportCrystalloid solutionsVitaminsNS { cannot exceed 0.9% [ ]KCL { cannot exceed 20 mEq

• VI What the EMT-B cannot transport

Piggy back or secondary set

Blood products

Antibiotics

Central line with fluid / medication infusing

• VII Responsibilities of the EMT-B when managing an IV

Keep the IV patent and maintain the desired rate.Handle the pt. in a way that will not

jeopardize the IV.To monitor and identify complications and take appropriate steps.

• VIII Complications

Over hydration

may cause pulmonary edema or CHF

{follow advice of medical control}

Clot occlusion

a blood clot has formed in or around IV catheter { follow advice of medical

control}

Infiltration

fluid is leaking into surrounding tissue

IV site will be cold and puffy

There is no blood return in the tubing

{follow advice of medical control}

Positional IV

IV may become occluded when pt. moves

catheter may rest against wall of vein

[ reposition the pt’s extremity, or IV tubing, Catheter/tubing connection]

{follow advice of medical control}

Pyrogenic ReactionDefined: Foreign material enter the body as

a result of contaminated fluidS / S: Abrupt elevation of temperature

chillsbackacheheadacheweaknessN / VOther s / s of shock

{Discontinue IV immediately}

{Contact and follow advice of medical control}

Allergic Reaction

A result of poor aseptic technique

{Contact medical control and follow advice}

• IX Types of catheters

The smaller the number, the bigger the needle.

14 to 20 gauge are common for adults

20 to 25 gauge are common for children

The length will vary from ½” to 3”

Multiplication and division

• Fractions

• Decimal fractions

• Proportions

• Percent

Mathematical Equivalents used in pharmacology:• Grams – mass• 1mg = 1cc• Meters – distance• Liters – volume

1L = 1000ml• Weight

1kg = 2.2lbs

Calculating dosages for infants and children

• Body weight

20ml/kg for hypovelemic shock

• Use of tables, charts and other adjuncts

Broslow Tape

Administration sets

• Macro

15gtts = 1ml

• Micro

• 60gtts = 1ml

• Fluid over time

Volume to be adm. (set)

time in minutes

Adm. 500 mL over 60 min. using 10 ggt set:

500 mL (10)

60

5000 / 60 = 83.3 or 83 gtts/min

• Infusion time

If you are transporting an IV antibiotic, how long before it will be infused?

Set: 60 gtt

Rate: 45 gtt/min

100 ml bag

45 gtt/min = (100 mL) (60 gtt set)

x

45 gtt/min = 6,000 mL gtt/min

x

X = 6,000 mL gtt/min

45 gtt/min

X = 133 minutes

Hypertonic

• higher solute [] than do the cells

• Shift – out of intracellular to extracellular

• Solute- dissolved in another substance

Hypotonic

• Lower solute [] than do the cells

• Shift – out of extracellular to intracellular

• LR is isotonic

• NS is isotonic

• D5W is hypotonic