How does that work?

Called for a patient unresponsive and breathing.

We arrive to find a male patient unresponsive, breathing and stable vital signs. The nursing home staff (all 6 of them in the room) tell me the patient’s SpO2 was in the 80’s but it got better with oxygen, applied via a nasal cannula 2 lpm. That’s all well and good, but the patient has a shiley trach. I additionally noticed a suction canister with 1000ml of pink fluid. I asked if that was all from today, one nurse said she left it there so I could see how much was suctioned from the patient over the last few hours.

First, I put my gloved finger over the patients trach, and magically watch the SpO2 rise. The nurse then says she cannot find the obturator. I give a listen to the lung sounds and hear, rales of course. Time to head towards the hospital. In the back of the ambulance I ask my partner to bag the patient via the trach, since CPAP is not available to me. I start an IV and consider my treatment options. We are only 1.5 miles from the hospital, I choose to just bag the patient for the short trip. I now noticed that the cuff on the trach is completely flat (which explains why I am not getting good respirations while bagging). I inflate the cuff and transport to the hospital.

Take note nursing students, placing a trached patient on a nasal cannula with out the obturator is a useless as….. well you get the point.

About Joel

I am a paramedic, firefighter and I work for an organ procurement organization. All stories related to work have been altered to HIPPA standards and for the protection of those involved. The personal stories are different. Photography, flying, aviation, hiking, camping, travel, geocaching, amateur radio are a few of my hobbies.
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