Archive for April 2011
Some patients will require cardiac monitoring. This can be done by applying electrodes to the patient’s skin and connecting electrical cables to a cardiac monitor. Three, five, or twelve electrodes are commonly placed to view the electrical activity of the heart when you are a paramedic or EMT professional.
Most electrodes are placed on the chest, abdomen or arms and legs. The placement is often based on practicality and how accessible an area is. The upper extremities are not usually used because they are often covered by clothing and artifact may be increased on the monitor due to extremity movement.
Before an electrode is applied there are certain steps that should be taken. First, identify the need for cardiac monitoring and determine the type of electrode placement you will need to use based upon the monitor system you are using. Second, expose the patient’s skin to the area of electrode placement and be sure that the area is dry and free of excess hair. The will ensure that the electrode adheres properly. Excess hair can be removed with a disposable razor in the area where the electrode will be placed. Third, remove the protective cover from the electrode and apply the electrode to the patient’s skin. Fourth, connect the cables to the electrodes. And finally, turn the cardiac monitor to the “on” position and double check that the correct monitoring view is selected.
There are many conditions that may require the use of a cardiac monitoring device. Some common conditions for using such a device include an altered mental status, an unresponsive patient, cardiac arrest, chest pain, respiratory distress, abdominal pain or discomfort, traumatic injuries to the chest, hypotension or diabetes.
As and emergency medical technician, your profession takes you to many different situations. You may not know that a particular call to assist someone is possibly a crime scene. Most crime scenes are evident by the presence of police in the area. If polices officers are not present when you arrive they may be on their way. Your first concern when ever you enter any scene is for your safety and the safety of your crew. If officers are present, stand by at a safe location near the scene until the police arrive or until they have secured the scene.
In some situations, you may not be aware that a violent crime has taken place when you enter the scene. If violence is evident while you are on the scene, call for police assistance immediately and ensure your own safety. This may require you to leave the scene without providing aid until the scene is secured by law enforcement.
If you enter a scene and discover that a crime has taken place there, you should request police assistance. It is possible that the crime was not yet reported. If this is the case, ensure that the perpetrator is no longer around before attempting to provide aid. Your primary concern must always be for your personal safety.
Once the scene is clear and your personal safety has been ensured, provide emergency medical care to the patient. Any time that you must delay providing medical care to a patient you should document the reasons for the delay. For example, if you must wait for police to arrive before entering a scene or if you have to leave a scene for safety reasons, you should document the situations that keep you from providing medical care.
If it is possible, do not disturb anything at the scene unless it is necessary for you to provide patient care. You should avoid disturbing blood trails, moving furniture, or relocating items at a scene that may provide clues about a crime that was committed there. If something must be moved, try and remember the exact location of the item before you move it and tell the police that you moved something.
