10 obsolete EMT skills. By EMS1.com

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prehospital spinal immobilization on backboards |
10 obsolete EMT skills
Gather round to learn the out-of-date and obsolete EMT skills that the Ambulance Driver has outlasted during his EMS career
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Pneumatic Anti-Shock Garments |
I only spell it out because if I said MAST or PASG, I’d still have to explain it to you young whippersnappers. See, back in the day we used to put these inflatable Velcro pants on shock patients, and when inflated, it raised their blood pressure. It did raise blood pressure very well — to the point that the patient bled pink from all the IV fluids we gave, but those magic pants sucked at saving lives.
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Manual defibrillation paddles |
You kids these days with your hippity-hop music and your iThings and your hands-free multifunction electrodes.… Why, in my day, when we wanted to defibrillate someone, we had these things called paddles. And you had to apply conductive gel to them and smear it around; then you had to press them on the chest with at least 25 pounds of paddle pressure
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Esophageal Obturator Airways |
Imagine if a Combitube and a BVM had a baby, and the airway baby inherited the worst features of each. The EOA was a supraglottic airway that was bulky, often caused trauma on insertion, did a poor job of isolating the trachea and protecting against aspiration and still required that you maintain a mask seal.
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Oral screws |
Picture — because I am afraid of what you might stumble across if you Google "oral screws" — if you will a little plastic doohickey shaped like a miniature ice cream cone with threads on the outer surface and a T-handle on the large end. And what you did was insert the small end of this doohickey between someone’s teeth when their jaws were clenched, and screwed it in until it forced their jaws apart.
When I was a paramedic student, my instructor took great pains to show us how to tear thin little strips of adhesive tape to secure IV catheters and endotracheal tubes. We fashioned elegant little chevrons of tape over the wings on our IV catheter hubs (seriously, they had wings) to secure them without obscuring the cannulation site. And we used to tear a one-inch strip of tape longitudinally for a few inches, wrapping one strip around the endotracheal tube and the other across the face like a big mustache.
Once upon a time, we used to think that acute pulmonary edema and decompensated congestive heart failure was caused by too much blood re-entering the lungs. We thought that if we could trap blood in the extremities, we’d reduce preload enough to relieve the pulmonary edema.
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Trendelenburg position |
For many years we fervently believed the Trendelenburg position was a vital treatment for shock. We thought that elevating the feet higher than the head raised blood pressure, and maybe even caused a couple units of blood to flow from the legs to the trunk.
Now that our current understanding of spinal cord injury acknowledges that prehospital spinal immobilization on backboards has virtually no supporting evidence and probably does more harm than good, we’re boarding far fewer people these days.
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External jugular IV access |
Honestly, I really miss this one. The EJ used to be my go-to vein in a code. I was already right there at the head intubating, and all it took was turning the patient’s head to one side a bit, sinking a 14-gauge in that fat, engorged vein, and you had the mother of all peripheral IV accesses.
Once upon a time, we used to take sadistic pleasure in rapid fire broadcasting to the brand-new dispatcher, "Dispatch, we’re 10-98, 10-8, 10-19, 10-18 to our 10-42, where we’ll be 10-7 for a few minutes for a 10-33 10-100. If we’re not 10-2 on that, we’ll be happy to 10-9."
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