Until now, ground ambulance and medical flight paramedics alike did not have a specific guideline to follow when treating patients with syncope. Syncope, otherwise known as fainting, happens when there’s a lack of blood supply and the blood pressure drops to deprive the brain of oxygen. And now the American College of Cardiology has released a guideline to help you understand the best course of action to take when encountering such patients.
What to do When You Encounter a Medical Flight Patient with Syncope
When you respond to a situation in which a patient has fainted, here’s what you need to do:
- It’s crucial that your initial evaluation includes a detailed physical examination and medical history. This will help you identify whether there are any possible underlying conditions that could result in the fainting.
- Fainting usually occurs while standing when there’s a drop in blood pressure, as this reduces oxygen supply to the brain. In most cases, the condition may not be life-threatening. So you should do your best to try and ease the worries of your patients.
- If your medical flight carries a portable ECG, it’s best that you use it during your evaluation. This will help you determine if there’s any abnormality that requires treatment.
- During your evaluation, if you find out that the patient has a serious medical condition that possibly caused the fainting, it’s crucial that they are transported to a hospital immediately. This holds true even if the patient seems to be recovering fine from the fainting.
- You can rule out the need for unnecessary evaluations such as routine lab testing and routine cardiac imaging such as CT scan or MRI unless you suspect the patient has a cardiac issue. There’s also no need for carotid artery or head imaging unless you need to perform a further evaluation.
These are some of the important guidelines to follow when encountering patients with syncope. Watch out for the next post to find out more.
When you’re operating an air ambulance, cleaning and disinfection of the aircraft would be a crucial part of your maintenance process. This decontamination process is essential for protecting both your air ambulance crew and your patients. So you might want to improve how you decontaminate your air ambulance transport vehicles to ensure the safety of everyone involved.
Checklist for Decontaminating Air Ambulance Transport Vehicles
Air ambulance decontamination needs to be thorough so as to reduce the risk of infections and diseases. Here are some of the basic steps you need to take:
- Use the right equipment – Decontamination of air ambulance vehicles can be time-consuming and complicated. So you’ll need to use a disinfecting equipment to ensure that the process is done more effectively and efficiently. Before you invest in one, make sure you choose equipment that’s easy to operate so you don’t have to spend more time in training your staff.
You should also consider the cost per use and evaluate the cost of all replacement parts and consumable supplies. It’s crucial that you evaluate various other aspects such as how effectively it eliminates pathogens, how quick the turnaround time is, and whether it has any limitations or shortcomings.
- Promote the use of new PPE – Advise your staff members not to wear the same PPE (Personal Protective Equipment) while decontaminating the air ambulance as they did when they were in contact with the patient. This could re-contaminate the areas they’re trying to clean, resulting in ineffective decontamination.
- Promote the use of fresh cot linens – After every patient, your air ambulance transport crew needs to change the cot linens. And they should do so after the clean the mattress using a disinfectant. This is because the porous material of cloth linen could allow microbes to infect the cot mattress.
In a previous post, we had discussed some tips on how to assess pediatric patients with suspected sepsis. You might have even confirmed your suspicion through the assessment and collection of patient’s medical history. So as a medical flight paramedic, what’s the next step you should take? While you may be compelled to immediately start treating the symptoms, it’s also important that you prioritize certain symptoms over others.
Treating Symptoms of Pediatric Sepsis for Medical Flight Paramedics
If you have a firm belief that your pediatric patient is suffering from sepsis, here are the treatments you should carry out in order of importance:
- Airway management – One of the most important initial treatment steps in sepsis patients is airway management. But it’s crucial that you are aware of the risks of using RSI/med facilitated intubation. This is because pediatric sepsis patients may be at risk of cardiac arrest as a result of induction agents.Breathing difficulty is common in sepsis patients. So your patient might find it difficult to breathe and may even require ventilation. Good ventilation will not only improve oxygenation but also reduce the oxygen demand as the patient will make less effort to breathe. Use CO2 monitoring to ensure proper ventilation.
- Circulation management – Pediatric sepsis patients will require normal saline (0.9% sodium chloride) for treatment. The initial amount you should administer is 20 ml/kg boluses over 5-10 minutes.
- Medications – You might have administered dopamine on previous medical flight patients with sepsis. But those are adults and the treatment is perfectly alright for them. The same isn’t true for pediatric patients. Instead, epinephrine should be administered in case of cold shock and norepinephrine in case of warm shock.
Sepsis is a tricky condition and experts haven’t yet determined the best treatment option. However, these recommendations should be ideal for pediatric sepsis treatment until there are new innovations in the field.
As a medical flight paramedic, you might have encountered a few sepsis patients on your missions. But have you had to deal with kids suffering from this problem? Sepsis treatment is already complicated and can be much more complicated in children. They can easily develop sepsis after developing an infection from a traumatic injury or an illness.
Pediatric Sepsis Assessment Tips for Medical Flight Paramedics
When you encounter a kid suspected of having sepsis, you can make use of the following tips to provide timely and accurate treatment:
- Assess complaints carefully – As you well know, there’s no test or clinical indicator for sepsis. So you need to carefully assess the various symptoms in your young patient to determine whether they’re suffering from the condition.
Fever, rash, vomiting, diarrhea, discharge or pus, foul-smelling urine, and runny nose are some of the common symptoms to look out for. If the patient is shivering, pale, sleepy, and suffering from shortness of breath and extreme discomfort, there’s a chance they have sepsis.
- Determine the patient’s medical history – In most cases, a patient’s medical history may make them more susceptible to sepsis. Try to determine if the patient has gone through anything that might decrease their immunity. For example, immunotherapy and chemotherapy as well as HIV/AIDS and regular steroid use can negatively affect the immune system.
You can also try to determine whether the patient suffers from any comorbidities that might leave them susceptible to infections and cardiovascular collapse. Cancer, sickle cell disease, cystic fibrosis, poor cardiac/respiratory reserves, and liver/splenic dysfunction are some conditions to look out for.
In addition to this, see if the patient has had any recent surgery, traumatic injury, indwelling devices, or organ transplants. Medical flight paramedics should also note that children who depend on mechanical ventilation may also be more susceptible to sepsis.
When you’re working as a medical flight paramedic, chances are that you have a hectic and sometimes unpredictable schedule. There may be times you have to work overtime, fill in for a co-worker, or even work a holiday shift. This makes it extremely difficult for those with children to find good child care options. In this post, you’re going to learn some useful tips to help you manage child care with your schedule.
Child care Options for Medical Flight Paramedics
When you’re a paramedic parent working busy and odd schedules, daycare may not be the most viable child care option for you. Here are some of the other options you could try:
- 24-hour daycare – While most daycare centers have fixed timings, a few 24-hour daycare centers have started opening up, providing parents working unconventional shifts with an excellent option. However, these centers may only be available at select cities and areas.
- Au pairs – Au pairs are fulltime nannies who live with you and are available to care for your kids during odd hours. Usually, their rates are considered per family and not per kids, so you could be saving plenty of money. But not many families are keen on the idea of having a nanny life with them.
- Nannies – If you’re not so keen on having your childcare provider live with you, you could opt to hire a nanny instead. They provide fulltime child care and then they go home after their shift. The main disadvantage of this is that they can be a bit more expensive than other child care options.
In addition to these, you also have the option of working out an agreement with a co-worker. There may be another medical flight paramedic working a different schedule than you and you could take turns watching each others’ kids. Or the two of you could combine your resources to save child care costs.