A 25 year old male with poorly controlled asthma presents with pneumonia and asthma exacerbation.
All of a sudden a new patient in cardiac arrest case comes to the ED. Your colleagues attend to the code but the emergency department is short on nursing staff. Your nurse has to help out with the code and cannot attend to your asthmatic patient. You decide to give duonebs, IV fluids, antibiotics and steroids without the help of the nurse.
How to use the Alaris infusion pump
Priming the bag
Clamp the tubing
Hang the bag
Remove the blue cap off the bag and insert the sharp end of the tubing without touching it (sterile)
Unclamp the tubing, let fluids run through the line and remove all the air from the tubing
Keep the cap at the end of the tubing until ready to attach it to the patient
Remove the light blue plastic cover and insert the tubing into the channel
Use an alcohol swab to clean the peripheral IV on the patient and test it with a saline flush
Attach the IV tubing to the patient
Press the ‘on’ button on the Alaris infusion pump
Hit ‘New patient’
Hit ‘Channel select’ (on the actual channel)
Chose ‘drugs’ or ‘IV fluids’ or ‘regular infusion’
Chose the rate
You’re done!
How to give nebulizers
Ask the patient if they want the face mask or hand held mouthpiece
Get the duonebs from the cabinet in the med room
The nebulizer kit is in the 5th drawer in every IV cart
Pour albuterol and ipratropium into the nebulizer well
Screw the cap on
Attach either a face mask or mouthpiece
Crank up the oxygen at 10 L
How to set up the Venti mask
The white knob allows to choose between 35%, 40%, 50% FiO2
The green knob is for 24%, 26%, 28%, 30% FiO2
After attaching the white or green knob place the transparent green plastic on top to secure it
Philip Siva Vittozzi Wong, MD is a current third year resident at Stony Brook Emergency Medicine.
References
Thanks to Marilin Dilone, RN and Briana Candito, RN for teaching me all this stuff
Alaris infusion pump - https://www.youtube.com/watch?v=gTQgmQ9N0wk
Edited by Bassam Zahid, MD