Category Archives: Tip of the Week

AV Blocks (Second Degree Type 2)

AV Blocks (Second Degree Type 2)
Posted on: Sep 16, 2013

Here is a tip and story to help you remember AV blocks (continuation).

Second Degree Type 2: The P-R interval is consistent; it’s just not always followed by a QRS complex.

So you decide to have a talk with your husband. He says he is going to try to not be late. The next few times he goes out he’s back on time (PR 0.12-.20) then BAM HE DOESNT SHOW UP (missed QRS).

HE IS CONSTANT BUT THEN FOR NO REASON DOESNT SHOW UP.

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AV Blocks (Second Degree Type 1)

AV Blocks (Second Degree Type 1)
Posted on: Sep 9, 2013

Here is a tip and story to help you remember AV blocks (continuation).The P-R interval gets progressively longer until a QRS is dropped. You decided to marry the guy who is always late so he decides he’s going to test his boundaries when he goes out with his buddies. He says he will be back at 1200 and the first night he is, the next night he goes out he comes back later – 1 am, the next night is later – 2 am, then the next night he’s so late you lock him out of the house! HE IS PROGRESSIVELY LATE and GETS LOCKED OUT.

But there is something about him you like and you forgive him and the cycle continues…late…late…late… locked out for the night!

Remember Wencke always comes bach!

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AV Blocks (First Degree)

AV Blocks (First Degree)
Posted on: Sep 4, 2013

Here is a tip and story to help you remember AV blocks.

First Degree: Look at the P-R interval, if it is longer than 0.20 seconds, it’s a first-degree AV block.

You are dating a guy and you tell him to pick you up at 8. Instead he picks you up at 8:30. This happens consistently every time you go out. HE ALWAYS SHOWS UP BUT IS CHRONICALLY LATE.

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Assessing Patients (SAMPLE)

Assessing Patients (SAMPLE)
Posted on: Aug 26, 2013

Remember, when assessing your patient use SAMPLE.

S – Symptoms
A – Allergies
M – Medications
P – Past medical history
L – Last meal eaten
E – Events leading up to the incident

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Inserting IVs

Inserting IVs
Posted on: Aug 19, 2013
When starting an IV, remember to go low and slow. Also when you feel the pop, drop. This is in reference to when you first insert the IV catheter as you do not want to go through the vein.
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D10W: Methods of Administration

D10W: Methods of Administration
Posted on: December 6, 2017

QUESTION: What is the best and most appropriate way to administer D10W?

Answer: Great question! There are actually a couple ways of doing so. Keep in mind that administering D10W to hypoglycemic patients is new to the majority of Paramedics in SWORBHP region; and that the appropriate dose is 0.2 g/kg (2 ml/kg) to a maximum of 25 g (250 ml). *updated for ALS-PCS 4.9 Feb 1, 2022

It’s likely that the D10W on your trucks is supplied in a 250ml bag (or similar), which means that you have far too much medication available in that one bag and are required to measure out the appropriate volume in order to administer the appropriate dose.

So, how do you measure out the appropriate volume?


CASE: Your hypoglycemic pediatric patient weighs 40 kg – the required dose is 8g and required volume is 80 ml.

Option 1: Set up an Inline Volumetric Cylinder (ie. Buretrol) to the bag of D10W and fill the chamber with 80 ml of fluid. Once filled with 80 ml, clamp above the chamber and run the line below. The inline Volumetric Cylinder prevents larger volumes of fluid inadvertently being infused.

Option 2: Use a large syringe to draw up 80 ml of D10W directly from the bag and administer via IV push (much like you would push D50W).

Note: SWORBHP does not support simply attaching the bag of D10W to an IV line and measuring volume administration via bag markers. One of the above two options must be used.

When selecting your option for administration, use clinical judgment and decide based on ease of use, safety, available equipment and timely medication delivery. Ensure you go through the RIGHTS of medication administration and perform an independent double check with your partner. The most important step is safety – safety of the appropriate dose, route, method, etc.

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