You’ve been there before. You’re getting ready to start an IV. You pull out the necessary supplies, you hand off the IV bag and drip set to a nearby firefighter and he (or she) looks back at you a bit sheepishly. “I’ve never really been any good at setting these things up right” they say.
Let me tell you the down and dirty truth, strait from a firefighter. No self-respecting firefighter should be unable to set up an IV line. Say what you will about patient assessment, vital signs, or splinting a broken limb, but IV lines are hydrodynamics. We use IV’s to take a fluid and transport it from one place to another, delivering water from its source through a flexible hose to a destination. Does any of this sound familiar?
Moving water around is what firefighters do. The problem here is that someone, maybe even you, taught that firefighter how to strip out and set up that IV line and you made it sound like a medical procedure. You probably told Mr. or Mrs. firefighter that the parts to the IV set up were things like an IV bag a drip chamber and a roller clamp. You may have described the process something like this.
1. Pull the caps off the IV bag and the drip chamber and connect them together. (Here you mention something about sterile technique.)
2. Lock down the roller clamp and squeeze the drip chamber once or twice to partially fill it.
3. Now open the roller clamp and let the saline fill the IV tubing.
Then you smiled that confident smile as if to say, “See how easy that was?” and 20 minutes later, your firefighter friend forgot all about that IV line and how to prepare it for battle.
Next time, let me give you a different approach. Let me give you a method
for showing firefighters how to strip out IV lines in a way that they’ll never forget. You see, firefighters, all firefighters already know how to set up IV lines. They do it every time they pull a hose line and charge it. Speak to them in the language that they already know and they’ll remember it later.
The next time you have to explain how to set up that IV, try this. Hold up the IV bag and say, “This is the water supply.” Hold up the IV line and point to the drip chamber and say, “This is the pump.” Refer to the IV line as the hose and the roller clamp as the nozzle. Now give these instructions.
1. Attach the drip chamber to the IV bag and say, “Connect your water supply to your pump.” (If you want to get fancy say, “Open the tank to pump.”)
2. Lock the roller clamp and say, “Shut down the nozzle.”
3. Squeeze the drip chamber and say, “Prime the pump.”
4. Open the roller clamp and say, “Open the nozzle and charge the line.”
When you teach it this way you accomplish two things. You provide the step-by-step instructions for getting the IV line all prepped and ready in a way that the dude or gal in the bunker coat will remember next time they’re assigned that duty. But you also send a subtle message that preparing an IV line is something the firefighter should know how to do already. You’re politely saying, “Look! It’s the exact same thing.” Now your fire friend will know how to do it right, but they’ll also know that they have no excuse to not know.
This technique has worked beautifully for me for a long time now. Let me know how it works for you.
Now it’s your turn: What techniques have worked for you when trying to teach others this skill. Have you found that this is a difficult skill for some responders to learn and retain? Who usually sets up the IV line in your system?
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