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wHUt we gonNA dU

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

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wHUt we gonNA dU

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  1. 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

  2. IV MAINTAINCE

  3. I Defined To manage and troubleshoot a pre-established IV line • II Three reasons for an IV line Volume Replacement Fluid Replacement Medication Route

  4. III Common Sites Lateral aspect of Upper Extremity Anterior aspect of elbow anticubital fossa Back of hand

  5. IV Common Fluids Crystalloid a. Does not contain proteins or large molecules b. Examples are D5W and NS Colloid

  6. a. Contains proteins or other large molecules b. Examples are albumin • IV The EMT-B can transport Crystalloid solutions Vitamins NS { cannot exceed 0.9% [ ] KCL { cannot exceed 20 mEq

  7. VI What the EMT-B cannot transport Piggy back or secondary set Blood products Antibiotics Central line with fluid / medication infusing

  8. 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.

  9. 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}

  10. 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}

  11. 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}

  12. Pyrogenic Reaction Defined: Foreign material enter the body as a result of contaminated fluid S / S: Abrupt elevation of temperature chills backache headache weakness N / V Other s / s of shock

  13. {Discontinue IV immediately} {Contact and follow advice of medical control} Allergic Reaction A result of poor aseptic technique {Contact medical control and follow advice}

  14. 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”

  15. Multiplication and division • Fractions • Decimal fractions • Proportions • Percent

  16. Mathematical Equivalents used in pharmacology: • Grams – mass • 1mg = 1cc • Meters – distance • Liters – volume 1L = 1000ml • Weight 1kg = 2.2lbs

  17. Calculating dosages for infants and children • Body weight 20ml/kg for hypovelemic shock • Use of tables, charts and other adjuncts Broslow Tape

  18. Administration sets • Macro 15gtts = 1ml • Micro • 60gtts = 1ml

  19. 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

  20. 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

  21. 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

  22. Hypertonic • higher solute [] than do the cells • Shift – out of intracellular to extracellular • Solute- dissolved in another substance

  23. Hypotonic • Lower solute [] than do the cells • Shift – out of extracellular to intracellular

  24. LR is isotonic • NS is isotonic • D5W is hypotonic

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