For what it's worth, it's more difficult on a psychological level than giving sub-q fluids to the cat.
I have one more live flash, one live full setup, and one live bloods to do before the end of the class. One nice thing about moving on to hospital clinicals is that my patient doesn't get to poke me in exchange for my starting an IV on them.
I'm almost done with the airway lab sign-offs; I have one left to do. I've placed endotracheal tubes, laryngeal mask airways, and combitubes into mannequins using various techniques; with c-spine precautions, without, using laryngoscopes, using just fingers to feel the epiglottis(!!!), on the table, on the floor, face-to-face. If you have a sick mannequin with a compromised airway, give me a call. I can't actually place tubes into human airways in Vermont until I'm a paramedic.
I still have a number of simulated trauma and medical (i.e., sick, not injured) assessments to do before Friday; four each. Those tend to be fairly straight forward; follow the A-B-Cs, treat what you find. I had an interesting medical assessment last Friday where I had to differentiate between asthma and anaphylaxis. It came down to skin tone; anaphylaxis is a systemic condition leaving the patient diaphoretic and pale where asthma is localized to the respiratory system. The simulated patient had multiple allergies and the history I was gathering was leading me to suspect anaphylaxis; he was in respiratory distress on my simulated arrival and not able to speak real well. Conveniently, I picked up on the pink, warm, and dry skin before I pumped the simulated patient full of simulated epinephrine. He'd have survived the epi, most likely, and his bronchiols would have been dilated, but albuterol was what was really called for.
By the way, if anyone says that you have 'great EJs', that's your cue to get up and run.
