I'm going to second this because sometimes a video like this is just what someone may need to help connect the dots. I'm frequently finding in the EMT/medic refreshers I help teach that meds and med administration can sometimes be a big struggle point for some. Sometimes just getting them hands on with this again is enough, though it is nice to have a video resources to reference as well or point others towards as extra study. At the very least, it's a great option to have available.
Great video! I use this technique in my practice and this is a good reminder. I usualy don't comment on your videos but here i want to show support for this form of content.
Just a quick question, when you add epi to the IV bag should you (shake, squeeze) the bag to mix it? And by the way, I am retired (mechanic) and had spent several years as an EMT with a volunteer fire department. I try to still stay current on SOP's even though I no longer respond. Thank you for all the great content!
sometimes the turbulence of shaking the bag will make the medication frothy. I honestly tilt the bag upside down once and then right side up and call it good!
What I find interesting is the use of pre-filled syringes to mix medication. As far as I know, the pre-filled syringes come with warning not to use them to mix medication. The Institute of Safe Medical Practices mentions not using the pre-filled syringes for anything else than flush. As a matter of fact, it also mentions not using a cartridge type syringe to draw medication from. Between you and me, I still do it but, it still goes against the 'recommended' practices. Thoughts?
My thoughts are that it comes down to money, storage, and use. Medications vials will say you can dilute with NS vs bacteriostatic water but it is for immediate use vs. letting it sit out for 24 hours before used (such as vecuronium). Flushes are labeled as "Not Sterile"; yet the saline inside the syringe is used in sterile procedures every day. Provided the sterile user and the sterile field did not come in contact with the "un-sterile" syringe. Someone has to squirt the saline into a sterile cup. I have seen your comment like you're on another video, yet I have never seen an answer. I also have never seen this type of claim on the flushes either, in any of the areas of practice that I have worked in, since flushes have made the scene. I honestly think it is a way for manufacturers to get more money out of the system. No one else seems to have an answer. Is it maybe a particular manufacturer that is putting this on the flushes? Maybe something happened and they had to "relabel" the product?
Hey, quick question. Do you have to wait for a period of time for the 1/1 epi to diffuse through the syringe? I mean to say, will the epi sit at the top of the syringe and you could potentially give a large dose from the top and no dose from the bottom?
No you don't you can use immediately however he didn't do it you just shake the syringe to mix it when it has a bit of air in it then dispel the air and push.
Since epinephrine works on alpha-1 AND beta-1 receptors, does that not mean epinephrine could be used in hypertension? If not, why not? I am curious (yes, I know epinephrine works on alpha-2, beta-2 and beta-3 as well). I presume there’s some nuance to this since it’s non-selective?
@krisdeaglephotography4539 so I think you are confused on what alpha 1 and beta 1 receptors do. Both contribute to increased cardiac output and vascular constriction. What would cause it to decrease blood pressure?
@@PrepMedic Beta-1. Beta always dilates and 1 works on the heart. Therefore does that not mean beta-1 acts as a vasodilator? Am I missing something or does beta-1 not work that way?
@krisdeaglephotography4539 beta 1 increases chronotropy and inotropy which both act to increase blood pressure. Beta 2 is smooth muscle relaxation which gives you some basic dilation but it’s certainly never going to drop blood pressure with Epi.
Hey, I got a question for you. I now have my lifeguard and CPR certification, and I have been carrying around a pocket CPR mask. I have not done any official training (like with a CPR dummy), however I have opened it up and tested it a couple times (then throw it out of course). They came in a pack of 7. My question is, is there a specific CPR mask brand/item that you personally recommend? I am looking for a quality one that I can become farmiliar with. Thanks!
@@JDLRodriguez it depends on what state you live in, but you probably don’t NEED to take EMT first, but a lot of people recommend you work as an EMT for a few years before becoming a medic.
@@JDLRodriguez What do you want to do with it and who do you want to work for? Every state is different and every organization that uses Paramedics have different requirements. Research who you would like to work for and go from there. If they will train you, all the better. Why pay out of your pocket if they will pay you train? Many large Fire Departments run their own EMS programs. Most Helicopter EMS want to see a few years of 911 experience plus you will need your Flight Paramedic certs unless they hire you with the stipulation that you will have that cert in X amount of time.
@@murvygoaz5903No one needs to work as an EMT before becoming a paramedic. That is a nonsense recommendation. Though some states require you to get an EMT license before you get a paramedic license.
Yeah…. Ohio would rather you mix epi into a bag of NS and eyeball it instead of PDP. 😑 Then again, they also think paramedics aren’t smart enough to use ultrasound, even though I teach ultrasound and I’m a paramedic. Weird. 😑
Great video, can you do more medication content please? I like the way you explain this.
I'm going to second this because sometimes a video like this is just what someone may need to help connect the dots. I'm frequently finding in the EMT/medic refreshers I help teach that meds and med administration can sometimes be a big struggle point for some. Sometimes just getting them hands on with this again is enough, though it is nice to have a video resources to reference as well or point others towards as extra study. At the very least, it's a great option to have available.
I swear it’s like you’re reading off of our protocols. We’re blessed to have a great medical director with great advanced protocols
Great video! I use this technique in my practice and this is a good reminder. I usualy don't comment on your videos but here i want to show support for this form of content.
Ha, you guys call it a tie-fighter as well! Good explanation of push dose Epi.
This is great!
Please more med vids.
IV nitro next please!
Everyone hates the dreaded paperwork! Good stuff sir! 👍
Video on dirty epi drip and how to calculate drip rate? I found other TH-cam videos done by other pips confusing.
We need more medication content!
Thanks sir 🙋♂️👍👍 beautifully explained ❤❤🌷🌷
Very informative. Thank you for the demonstration.
Great Training and review of basic task. Keep it up!
Medication Math is ruled by the decimal.
1:1000 Epi 1mg per 1cc=100mcg/0.1cc
vs
1:10,000 Epi 1mg per 10cc 100mcg/1cc
thank God for the metric system!
"Just don't stab yourself because it's a lot of paperwork and it's really embarrassing." Words to live by. :)
😂
Great explanation, thank you
Thanks Sam. Great content.
Just a quick question, when you add epi to the IV bag should you (shake, squeeze) the bag to mix it? And by the way, I am retired (mechanic) and had spent several years as an EMT with a volunteer fire department. I try to still stay current on SOP's even though I no longer respond. Thank you for all the great content!
sometimes the turbulence of shaking the bag will make the medication frothy. I honestly tilt the bag upside down once and then right side up and call it good!
What I find interesting is the use of pre-filled syringes to mix medication. As far as I know, the pre-filled syringes come with warning not to use them to mix medication. The Institute of Safe Medical Practices mentions not using the pre-filled syringes for anything else than flush. As a matter of fact, it also mentions not using a cartridge type syringe to draw medication from. Between you and me, I still do it but, it still goes against the 'recommended' practices. Thoughts?
My thoughts are that it comes down to money, storage, and use. Medications vials will say you can dilute with NS vs bacteriostatic water but it is for immediate use vs. letting it sit out for 24 hours before used (such as vecuronium). Flushes are labeled as "Not Sterile"; yet the saline inside the syringe is used in sterile procedures every day. Provided the sterile user and the sterile field did not come in contact with the "un-sterile" syringe. Someone has to squirt the saline into a sterile cup.
I have seen your comment like you're on another video, yet I have never seen an answer. I also have never seen this type of claim on the flushes either, in any of the areas of practice that I have worked in, since flushes have made the scene. I honestly think it is a way for manufacturers to get more money out of the system. No one else seems to have an answer. Is it maybe a particular manufacturer that is putting this on the flushes? Maybe something happened and they had to "relabel" the product?
My protocol is 10-20 mcg every 2 min. I have a 30 min transport, solo!! Is there a way to mix push dose into a NS bag and deliver it hands free?
They let you bring the Rx meds home?
What is a tie fighter on the aircraft ?
Love using this. Just need to commit Phenylephrine to memory like I have epi
Hey, quick question. Do you have to wait for a period of time for the 1/1 epi to diffuse through the syringe? I mean to say, will the epi sit at the top of the syringe and you could potentially give a large dose from the top and no dose from the bottom?
No you don't you can use immediately however he didn't do it you just shake the syringe to mix it when it has a bit of air in it then dispel the air and push.
Can you do one for IV Acetaminophen?
didn't think i'd get an answer what they were doing in the ambulance 2 months ago 3:31
Sam what is your take on virtual reality Critical Care simulation eg SimXVR and Oculus Meta Quest 3 ?
Haven’t used them so can’t really have an opinion yet.
Since epinephrine works on alpha-1 AND beta-1 receptors, does that not mean epinephrine could be used in hypertension? If not, why not? I am curious (yes, I know epinephrine works on alpha-2, beta-2 and beta-3 as well). I presume there’s some nuance to this since it’s non-selective?
You mean used to treat hypertension?
@@PrepMedic Yes.
@krisdeaglephotography4539 so I think you are confused on what alpha 1 and beta 1 receptors do. Both contribute to increased cardiac output and vascular constriction. What would cause it to decrease blood pressure?
@@PrepMedic Beta-1. Beta always dilates and 1 works on the heart. Therefore does that not mean beta-1 acts as a vasodilator? Am I missing something or does beta-1 not work that way?
@krisdeaglephotography4539 beta 1 increases chronotropy and inotropy which both act to increase blood pressure. Beta 2 is smooth muscle relaxation which gives you some basic dilation but it’s certainly never going to drop blood pressure with Epi.
Hey, I got a question for you. I now have my lifeguard and CPR certification, and I have been carrying around a pocket CPR mask. I have not done any official training (like with a CPR dummy), however I have opened it up and tested it a couple times (then throw it out of course). They came in a pack of 7. My question is, is there a specific CPR mask brand/item that you personally recommend? I am looking for a quality one that I can become farmiliar with. Thanks!
how do you have either cert without physical training with a cpr dummy?
@@markrein6904 When I was in lifeguard training we trained with the CPR dummy.
I want to know exactly what I need to do to be a paramedic?
attend and pass a paramedic course, pass the NREMT exam, apply for your state license
Thank you bit i need to take emt first before paramedic like is mandatory or is recommended to take emt know the basics then go to paramedic
@@JDLRodriguez it depends on what state you live in, but you probably don’t NEED to take EMT first, but a lot of people recommend you work as an EMT for a few years before becoming a medic.
@@JDLRodriguez What do you want to do with it and who do you want to work for? Every state is different and every organization that uses Paramedics have different requirements. Research who you would like to work for and go from there. If they will train you, all the better. Why pay out of your pocket if they will pay you train? Many large Fire Departments run their own EMS programs. Most Helicopter EMS want to see a few years of 911 experience plus you will need your Flight Paramedic certs unless they hire you with the stipulation that you will have that cert in X amount of time.
@@murvygoaz5903No one needs to work as an EMT before becoming a paramedic. That is a nonsense recommendation. Though some states require you to get an EMT license before you get a paramedic license.
Hi Sam
What? No Pulp Fiction reference?💁🏻♀️
Ever work in a ditch, long term? No pumps in a ditch.
We actually carry pumps on our trucks 😊
We can grab it and take it into a ditch with us.
Yeah…. Ohio would rather you mix epi into a bag of NS and eyeball it instead of PDP. 😑 Then again, they also think paramedics aren’t smart enough to use ultrasound, even though I teach ultrasound and I’m a paramedic. Weird. 😑
For anyone who doesn't know what a "Tie Fighter" is, it's slang for a 3-way stopcock
It isn’t actually. It is a female to female connector without a dial.