BLS Epi in cardiac arrest?

[blindsideflank]

Are there any BLS services out there giving epi Q5 for all cardiac arrests (while continuing the AED analyze and shock every 5 cycles).

I know there is controversy regarding epi in cardiac arrest but it is the standard in ALS and ED codes. Perhaps amio/lido and bicarb etc. are too much for BLS but what are your thoughts on BLS crews doing 5 cycles, analyze, shock or dont then epi Q5?

I put this in the ALS forum to stimulate a better discussion but if it truly belongs in the BLS section then please move it.

 

[STXmedic]

Well you'd have to have a route to administer it. EMTs with IV capabilities has been discussed ad nauseum here. IOs in a full arrest could be a potential. How long is your normal wait for ALS to arrive on scene?

 

[blindsideflank]

no ALS in this area (my old job) and this is how it is in all rural areas in british columbia. Also, almost every PCP here has IV endorsement. If you cant get a line then continue with the current status quo? (5 cycles of CPR and after 3 no shocks you transport? sorry i dont remember the BLS "protocol")

i didnt know it was common that EMT's cant perform IV's

 

[Medic Tim]

no ALS in this area (my old job) and this is how it is in all rural areas in british columbia. Also, almost every PCP here has IV endorsement. If you cant get a line then continue with the current status quo? (5 cycles of CPR and after 3 no shocks you transport? sorry i dont remember the BLS "protocol")

i didnt know it was common that EMT's cant perform IV's

The emt in the usa is closer to our emr or the ofa3 than pcp.
I don't see pcps getting epi 1:10000 anytime soon. The effectiveness of it has been questioned for years.

 

[Mariemt]

Could stab um with an epi pen:rofl:

 

[Handsome Robb]

Could stab um with an epi pen:rofl:

Minus the whole lack of blood flow that's required to absorb IM meds.

Epi bristojets are dummyproof but like someone said, without a route to administer it what's the point unless you plan on dumping it down the KING airway but that's an even worse idea.

 

[NomadicMedic]

I've removed off topic posts.

 

[WBExpatMedic]

No disrespect intended, but what's the point of having different levels of providers if we allow basic's or it's equivalent to provide ALS care. As a basic I was frustrated with not being able to provide a higher level of care so I went to medic school. We need to have the education to back up the decisions we are making.

 

[hogdweeb]

No disrespect intended, but what's the point of having different levels of providers if we allow basic's or it's equivalent to provide ALS care. As a basic I was frustrated with not being able to provide a higher level of care so I went to medic school. We need to have the education to back up the decisions we are making.

this. exactly why im starting medic school next fall. I hate providing oxygen, comfort and ASA to patients and thinking im helping them.

 

[Carlos Danger]

Could stab um with an epi pen:rofl:

Actually, it would probably work as well as IV epi.....

this. exactly why im starting medic school next fall. I hate providing oxygen, comfort and ASA to patients and thinking im helping them.

Do you really not think that oxygen, comfort, and ASA help your patients?

Nothing wrong at all with wanting to advance your level of practice, but don't sell yourself short as "just a basic". In many (if not most) cases, the interventions that are provided by a good EMT-B are the only ones that have actually been proven to have a positive impact.

With the exception of a few specific scenarios, I would honestly just as soon have my family taken care of by a good basic as by a paramedic.

 

[Mariemt]

this. exactly why im starting medic school next fall. I hate providing oxygen, comfort and ASA to patients and thinking im helping them.

These are also very important treatments.
As is sometimes listening to your suicidal psyche patient, talking to your dementia patient who doesn't even understand and letting them know you are there to help with your bls skills

 

[broken stretcher]

this. exactly why im starting medic school next fall. I hate providing oxygen, comfort and ASA to patients and thinking im helping them.

dumb statement. im a better PROVIDER than most medics i work with and I'm a basic. EMS before ALS. if the patients cared for and comforted in their time of need and i can get them to more definitive care than that is a job well done. thats the problem with SOME ALS providers. they forget about the pt's and just go robo-medic through their protocols and forget that they have a person to care for and comfort. and its not all their fault. a lot of them are scared that some doctor is gonna widen their :censored: if they :censored::censored::censored::censored: up so they focus on the protocols and not the pt.

 

[Mariemt]

EMS before ALS.

ALS is EMS

 

[Handsome Robb]

dumb statement. im a better PROVIDER than most medics i work with and I'm a basic. EMS before ALS. if the patients cared for and comforted in their time of need and i can get them to more definitive care than that is a job well done. thats the problem with SOME ALS providers. they forget about the pt's and just go robo-medic through their protocols and forget that they have a person to care for and comfort. and its not all their fault. a lot of them are scared that some doctor is gonna widen their :censored: if they :censored::censored::censored::censored: up so they focus on the protocols and not the pt.

Because EMTs never make this mistake. Only paramedics with our ALS skills can have a poor bedside manner

Honestly, us rather have a competent medic who's an :censored::censored::censored::censored::censored::censored::censored: but knows their stuff inside and out than a sub par medic who makes me feel all warm and fuzzy. I'm sure there are many out there that agree with me.

 

[chaz90]

Honestly, us rather have a competent medic who's an :censored::censored::censored::censored::censored::censored::censored: but knows their stuff inside and out than a sub par medic who makes me feel all warm and fuzzy. I'm sure there are many out there that agree with me.

Oh, I've said before that given those two options, the competent jerk would be my preference as well. Given the general populace however, we're in the minority. Most people don't know if they were treated with good medicine. All they notice or remember is how they were treated as a person. The good point made earlier though was "Why not have both?" Fortunately, the real world doesn't separate it with only those choices available.

 

[Wheel]

ALS is EMS

Yeah I'm not sure what they meant by this statement. Probably BLS before ALS, which wouldn't be a lot better.

 

[Mariemt]

Because EMTs never make this mistake. Only paramedics with our ALS skills can have a poor bedside manner

Honestly, us rather have a competent medic who's an :censored::censored::censored::censored::censored::censored::censored: but knows their stuff inside and out than a sub par medic who makes me feel all warm and fuzzy. I'm sure there are many out there that agree with me.

Well you know there is no such thing as a nice medic or a jerky EMT

 

[Bullets]

this. exactly why im starting medic school next fall. I hate providing oxygen, comfort and ASA to patients and thinking im helping them.

The vast majority of your patients probably only need that, if that much

If someone can show a benefit of Epi in cardiac arrest then there may be room for conversation, but even then, how would BLS administer the medication?

I dont see a need for it

 

[Medic Tim]

The vast majority of your patients probably only need that, if that much

If someone can show a benefit of Epi in cardiac arrest then there may be room for conversation, but even then, how would BLS administer the medication?

I dont see a need for it

I agree. If there was evidence showing that epi actually led to better outcomes I would be all for it.

Also keep in mind the BLS being refered to here are like AEMTs in the us. They already do IVs and several meds.

 

[omak42]

Actually, it would probably work as well as IV epi.....




Do you really not think that oxygen, comfort, and ASA help your patients?

Nothing wrong at all with wanting to advance your level of practice, but don't sell yourself short as "just a basic". In many (if not most) cases, the interventions that are provided by a good EMT-B are the only ones that have actually been proven to have a positive impact.

With the exception of a few specific scenarios, I would honestly just as soon have my family taken care of by a good basic as by a paramedic.

That last statement is a pit fall of the systems you have seen apparently. The area I work, as well as myself, strive to ensure paramedics continue to provide great bls care while adding als....I know its an issue all across the country (probably world) and sadly its a training/mindset issue