# Medications EM-B's can use.



## jeepmedic

I am courious as to the diffrent protocals around the country. What medications can EMT-B's adminster in the wide range of area covered in this Forum?

Here in Western Virginia EMS Council EMT-B' can adminster Oxygen, Oral Glucose, and ASA ({2} 81mg baby) on standing orders, also Epi Pen, NTG, MDI and Nebulized Albuterol under online Medical Control.

I would like to see them given Glucagon for Hypoglycemia, but that may come in the next protocal update.


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## Epi-do

Here we can do oxygen, ASA, oral glucose, NTG, epi-pens, and albuterol inhalers.  The last three we can only "assist" with and the patient must already have the medication.


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## ffemt8978

We can administer O2, ASA (162mg), oral glucose, activated charcoal and EPI-pens to any age patient.  We can assist with NTG, MDI, and nebulizers.


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## c-spine

In my area of WI, we can give O2, 325mg ASA, Oral Glucose, Activated Charcoal; and can assist with NTG (with medical control OK), nebs, epi-pen


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## emtbuff

In Iowa we are allowed to give oral glucose, ASA (2- 81mg), and O2; Assist with pt prescribed inhalers, epi-pens, and nitro.  We can get medical control for additional Nitros and activated charcoal.  I believe thats it.


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## Medivixen

IV's with D10W and NS
glucagon, oral glucose and thiamine
nitro and ASA
epinephrine and benadryl
ventolin
entonox
narcan


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## MICU

Over here we can only provied:
O2
Aspirine (after a course)
Pain killers (Acamoll/ Aoptalgin)
And Saline 0.9% IV 

Thats the drugs we have on the BLS amb.


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## FFEMT1764

Here the basic's can give oxygen(obviously, so can a first reponder), epi-pen, mdi, and NTG all with online med control, and oral glucose under standing orders. Thats about all the med control will allow basics can do. Everything else reqiures a medic.


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## KEVD18

epi
asa
glucose
ntg(pre prescribed)
mdi"                   "
charcoal(med control)

nebs are authorized by the state, however are optional. meaning that its up to each service and their inherent medical director to decided if that service will make use of the med. my service is to cheap to do the training and buy the meds.


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## Guardian

jeepmedic said:


> I am courious as to the diffrent protocals around the country. What medications can EMT-B's adminster in the wide range of area covered in this Forum?
> 
> Here in Western Virginia EMS Council EMT-B' can adminster Oxygen, Oral Glucose, and ASA ({2} 81mg baby) on standing orders, also Epi Pen, NTG, MDI and Nebulized Albuterol under online Medical Control.
> 
> I would like to see them given Glucagon for Hypoglycemia, but that may come in the next protocal update.



glucagon is a big boy medication, sorry


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## trauma1534

Guardian said:


> glucagon is a big boy medication, sorry



uhhh... anyone can give any medication when properly trained, and taught the indications and contraindications thereof.  

Another thing.... what would it harm for anyone to be able to give Glucagon?


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## c-spine

I don't think it would hurt anything; but it's one of those "we have always done it this way, and WILL always do it this way.....until we decide to change it" sort of things.


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## jeepmedic

Guardian said:


> glucagon is a big boy medication, sorry



Glucagon is an EMT-B drug that has to be approved by the OMD for an EMT-B to use.


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## SC_EMT

Here we can give asa, epi, nito, charcoal, ipecac, o2, im atropine, umm i think thats it.


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## Jon

In PA:

O2
Activated Charcoal - 1x by standing order, then Call Command
Oral Glucose - 1x by standing order, then Call Command
Epi-Pen (with special training, carried by EMS)  - 1x by standing order, then Call Command

Patient's own:
Nitro Spray or Tab - 1x by standing order, then Call Command
Epi Pen - 1x by standing order, then Call Command
Albutorol Inhaler - 1x by standing order, then Call Command


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## Ridryder911

The general : oxygen, assist in NTG, Inhalers, ASA, and activated charcoal. Now, with that saying many ER physicians are requesting that non-cardiac monitored patients no-longer receive NTG, and activated charcoal due to recent studies of new treatments of poisonings. 

I am on a committee to adress in allowing Basics to place CPAP for CHF patients.

R/r 911


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## MeckRS83

Ridryder911 said:


> The general : oxygen, assist in NTG, Inhalers, ASA, and activated charcoal. Now, with that saying many ER physicians are requesting that non-cardiac monitored patients no-longer receive NTG, and activated charcoal due to recent studies of new treatments of poisonings.
> 
> I am on a committee to adress in allowing Basics to place CPAP for CHF patients.
> 
> R/r 911



Personally, I think that EMT-B's are being taught just enough about meds to get themselves into trouble.  I think other than 02, they should not be able to touch any other drugs.  Too much can go wrong.


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## Recycled Words

In New Jersey

O2
Oral Glucose
Epi-Pen (patient's own)
MDI (patient's own)
Nitro (patient's own)

We have standing orders for all of these so we don't need to call medical control unless there's some sort of out-of-the-ordinary senario.

Supposedly they're considering letting us carry Epis and MDIs as well as a few other things and maybe letting us start IVs but of course they're going to talk about it for a year and then it'll never happen, so....


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## KEVD18

MeckRS83 said:


> Personally, I think that EMT-B's are being taught just enough about meds to get themselves into trouble.  I think other than 02, they should not be able to touch any other drugs.  Too much can go wrong.




using ma emt standards, i would like qualification of that statement
the meds i can give are as follows:

epi
asa
glucose
ntg(pre prescribed)
mdi" "
charcoal(med control)

how can i hurt my pts administering these medications following protocols with the proper training and con ed?

epi pen: i respond to a call for a 14yo m pt with facial edema and resp distress. pmh reveals anaphalaxyis to peanuts. mom rpts pt had some cookies at teh neighbors house. neighbor is on scene and reports that there were peanuts in recipe. pt resp distress progresses fast. hosp is 15min away. als is ten. does my pt have ten minutes??????

oral glucose: respond to the pt c/o dizziness nausea confusion and tremors. pt wearing a medica alert bracelet stating iddm. cbg-58.
how is glucose going to hurt this pt? 

ntg: pt co substernal cp radiating into left arm and jaw, 10/10. pale and diaphoretic. bp: 170/96 hx of angina and a mi two yrs prior. sounds like a great to admin both asa and ntg

mdi: has to be pre prescibed, so how is it going to hurt if i help the pt by doing the squeezing?????


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## Medivixen

> Originally Posted by MeckRS83
> Personally, I think that EMT-B's are being taught just enough about meds to get themselves into trouble. I think other than 02, they should not be able to touch any other drugs. Too much can go wrong.



If taught in school and able to demonstrate competence in pharmacology/pharmacodynamics/pharmacokinetics and physiology of the drugs we are able to give there is no reason why we should not be able to give these and other drugs that will be comming into our scope of practice in the near future. That is why we have protocols and licensing boards.


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## fm_emt

Recycled Words said:


> Supposedly they're considering letting us carry Epis and MDIs as well as a few other things and maybe letting us start IVs but of course they're going to talk about it for a year and then it'll never happen, so....



I've heard rumors that they might let us administer Epi (with an epi-pen) in the near future. Even if we have to take an 8 hour class just for the epi-pin, that's fine with me. We've run into a few situations where an epi-pen would have been great to have and use, but we didn't have it & couldn't use it. 

I think that in the case of things like Epi-pens, we oughta be able to use them, especially since any Tom, ****, or Harry can get one from Walgreens. yes, they're prescribed, but shared around with impunity.

Same with ASA. Want us to take a special class for it? Sure, I have no problem with that.


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## MICU

Is it me or our BLS team is the only one without any real drugs.


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## Guardian

trauma1534 said:


> uhhh... anyone can give any medication when properly trained, and taught the indications and contraindications thereof.
> 
> Another thing.... what would it harm for anyone to be able to give Glucagon?



well, for starters, they could accidentally kill someone.


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## trauma1534

Guardian said:


> well, for starters, they could accidentally kill someone.




Now tell me how Glucagon can kill someone?

And on top of that, Morphine can kill someone, valume can kill too.  Nitro can cause someone to bottom out and it not corrected it too can kill someone.  Every drug on the truck can kill someone no matter what level is giveing the drug.  

I think we are just making excuses as to why EMT-B's can't function.  

Anyone can have an allergic reaction to any drug.  If not corrected, it can kill someone.  

Any EMS provider is one patient away from possably killing someone!  Let's not get tunnel vision folks!


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## FFEMT1764

trauma1534 said:


> Every drug on the truck can kill someone no matter what level is giveing the drug.


 

I have never heard of Narcan killing anyone. Same thing for oxygen. I think that basic's should have a few drugs, nothing fancy though. Simple stuff like D50, Albuterol, and maybe diphenhydramine.  The rest should be maintained to the ALS level...and I don't think basics should do any cardiac meds as they need to be monitored while being given the meds.


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## jeepmedic

FFEMT1764 said:


> I have never heard of Narcan killing anyone. Same thing for oxygen. I think that basic's should have a few drugs, nothing fancy though. Simple stuff like D50, Albuterol, and maybe diphenhydramine.  The rest should be maintained to the ALS level...and I don't think basics should do any cardiac meds as they need to be monitored while being given the meds.



Glucagon is a lot safer than D-50. Glucagon should be used with caution on pts using blood thinners (Warfarin), and beta-blockers (propranolol). Also with pts who are pregnant. 

Now if you give D-50 you have to have an IV. And if that IV should blow while you are giving the drug guess what? You have tissue necrosis.


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## FFEMT1764

Our protocols, statewide, require IV attempts prior to giving glucagon, so thats why the D50 reference. And that would only be given by our EMT-I's as basics cant do IV's here, yet. That may change in a few years...depends on the state EMS med director.


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## trauma1534

FFEMT1764 said:


> Our protocols, statewide, require IV attempts prior to giving glucagon, so thats why the D50 reference. And that would only be given by our EMT-I's as basics cant do IV's here, yet. That may change in a few years...depends on the state EMS med director.



Good attempt to come back, but the topic is Drugs EMT-BASICS can give.  We were first discussing with your previous posts that you thought that EMT-B's should be allowed to give D-50.  Now you are changing it to I's???  Dude, I's can already give everything a Paramedic can in this area, except for RSI.  That is the single only difference between the two here.


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## Pablo the Pirate

well i think with the proper training just about anyone can give drugs.  EMT-Bs are by no means stupid and they are highly trainable.  Remember that all "Paragods" started out as "nothing better" than EMT-Bs.  Medics may save lives but basics save your paramedic :censored: :censored: .  It kinda sounds like some of you should remember that.  with that being said as a basic i could give 325mg ASA, Nitro that we carry, glucagon, oral glucose, O2 of course, albuterol nebs, and NS IVs all that standing orders.  with med control Activated charcol and Epipen.  and it's not really a med but we combitube also.  In my section of the US basics can do alot of skills and i think it's great. thats just my 2 cents


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## jeepmedic

Pablo the Pirate said:


> well i think with the proper training just about anyone can give drugs.  EMT-Bs are by no means stupid and they are highly trainable.  Remember that all "Paragods" started out as "nothing better" than EMT-Bs.  Medics may save lives but basics save your paramedic :censored: :censored: .  It kinda sounds like some of you should remember that.  with that being said as a basic i could give 325mg ASA, Nitro that we carry, glucagon, oral glucose, O2 of course, albuterol nebs, and NS IVs all that standing orders.  with med control Activated charcol and Epipen.  and it's not really a med but we combitube also.  In my section of the US basics can do alot of skills and i think it's great. thats just my 2 cents



You have opened that can of worms again. :unsure:


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## FFEMT1764

trauma1534 said:


> Dude, I's can already give everything a Paramedic can in this area, except for RSI. That is the single only difference between the two here.


 

I thought VA had EMT-shock trauma. I didnt know they also had I's.  I think that the whole EMT I thing should go away, and I was and I for 8 years...update the B program and beef them up, do away with the I, and then just have B and P.  Just a thought though.  And it is interesting that an I can give controlled meds...but hey if thats allowed there good for you.


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## jeepmedic

FFEMT1764 said:


> I thought VA had EMT-shock trauma. I didnt know they also had I's.  I think that the whole EMT I thing should go away, and I was and I for 8 years...update the B program and beef them up, do away with the I, and then just have B and P.  Just a thought though.  And it is interesting that an I can give controlled meds...but hey if thats allowed there good for you.



VA. changed the levels about 2 or 3 years ago. we now have EMT-Basic; EMT-Enhanced; EMT-Intermedite; and EMT-Paramedic. I think it is to many levels but In some areas of the state you don't have any where for the providers to take a EMT-Intermedite or Paramedic class. The Enhanced is almost the same thing as a Shock Trauma.


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## FFEMT1764

Ok i was wondering...now I am no longer confused. Thanks for explaining it. I know MD still has the CRT (or did when I moved back here in 2000)


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## jeepmedic

FFEMT1764 said:


> Ok i was wondering...now I am no longer confused. Thanks for explaining it. I know MD still has the CRT (or did when I moved back here in 2000)



I'm glad you are not confused because I teach here and I am :wacko:


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## fyrdog

Eventually EMT-Bs will be giving all the meds that paramedics can give. The easiest way to get to that point is to become a paramedic now and you wont have to wait. I dont understand why places take the paramedic ciriculum and strip it down so EMTs can do part of it. 

If you want to do paramedic stuff become a paramedic. It's as important to learn why you doing something as it is to learn how to do it. It is also important to know why not to do something when everyone thinks you should.

I do think some of the additions for EMTs are good ie. AEDs assisting a patient with thier medications, assistining with setting up IVs and EKGs. 

And I do believe EMTs are valuble to paramedics and should be treated with respect and included as team players.


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## davis513

Well I didn't see anyone post for North Carolina so here goes...

Per the North Carolina Medical Board's "Approved Medications for Credentialed EMS Personnel" revised as of 05-02-2006:

"EMS personnel at any level who administer medications must do so within an EMS system that provides medical oversight. Personnel must follow written treatment protocols and must complete appropriate medical education. All EMS System protocols and policies must be reviewed and approved by the Medical Director of the Office of EMS."

The List for EMT-B's includes:

Acetaminophen

Aspirin

Atropine (As a component of preparedness for domestic terrorism, EMS personnel recognized by the EMS System may carry, self-administer or administer to a patient atropine and/or pralidoxime, based on written protocals and medical direction, by auto-injector only.

Beta Agonist Preparations (Limited to patients who are currently prescribed the medication. EMT use may be through any inhaled method of administration).

Activated Charcoal

Diphenhydramine - (oral route only)

Epinephine - (Liminted to treatment for anaphylaxis and may be administered only by auto-injector).

Narcotic Antagonists - (Limited to naloxone by intra-nasal route).

Nasal spray decongestant

Nitorglycerin - (Limited to patients who are currently prescribed the medication.)

Non-prescription medications

Non-steroidal anti-inflammatories

Oxygen (Does not require medical directions)

Pralidoxine (As a component of preparedness for domestic terrorism, EMS personnel recognized by the EMS System may carry, self-administer or administer to a patient atropine and/or pralidoxime, based on written protocals and medical direction, by auto-injector only.


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## Ridryder911

Pablo the Pirate said:


> Remember that all "Paragods" started out as "nothing better" than EMT-Bs.


 

I do wish people would stop saying that.. Nearly half of my staff was never a Basic EMT...nor practiced as such, and they are very good medics. In many locations one has to never has to be a Basic EMT. In fact most of our Paramedic programs are now suggesting entry level from nothing to Paramedic level. This was from suggestions by local EMS administrators whom preferred to hire Paramedics and develop "their own" style without any predisposed attitudes. 

So not (all) Paramedics were Basic levels... that is a myth. 

I am wondering what "non-steroid anti inflammatories" they are administering?

R/r 911


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## Stevo

why am i constantly reading here that a paramedic is the end all solution to ems?

yes i like paramedics when it gets heavy

no , they are not needed on every single call

yes, a  good emt recognizes the need for a paramedic

no, emt's are not playing _paramedic_ in their absence

it's been that way here for decades, and it has managed to work rather well imho...

~S~


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## Ridryder911

I understand we are not needed on every call... but would it not be better to be have one on every call then to have to wait or not have one at all ? An AMI, patient with extreme pain, respiratory distress, MVC's may not need one but again having the patient to await an additional ten minutes for that breathing treatment or antiarrhythmic or chest decompression can and does mean the difference between life and death..... So yes we have been doing certain things for decades, but this does not mean they are always right.

R/r 911


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## Stevo

it would be best to have an MD on every call for the patient's benifit ,but it's unrealistic to expect it, and the cost of instituting anything like that (as an emt-p) via _mandatory_ requirement would sink ems overnight

and i personally think the majority of what i see _not working_ in ems is due to the changes being made by the powers that be. 

they are constantly trying to fix what is not broken, and provide little to nothing for validation in doing so.

i am not going to bow down to their, or your _what if_ sceanrios *Ryder* , they are about as valid as _what if the earth flys into the sun, we need more blitz line_

IF you want change, start at the bottom, not the top. convince basics , as well as dispatch, of the need for als, what to look for, when to call

a good basic will always be als's biggest advocate, to base your assumption that change is needed because basics and I-techs try to play paramedic is the biggest crock i've heard in my entire carear

i highly suspect that your constant lamenting of basics , their training, thier street performance is a manifestation of your personal frustration ...

let it go

~S~


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## az_emt18

*Meds. Emt-B's can use In Arizona*

Here in Arizona we are allowed to administer ASA, Oxygen, Oral Glucose, Epi-Pens, And we are allowed to assist with Nitro, albuterol inhalers under medical control.


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## Ridryder911

You are right about my frustrations of receiving patients that are not intubated and having aspirated GI contents into their lungs, or the trauma patient that had a simple pneumo that now has a tension pneumo, as well as the "protocol driven EMS" that gives NTG to every chest pain only to KILL that patient with an inferior wall AMI...Why?.. 

Because they did not have ALS or the education level!.. Now I see incidences like these at least twice a month... maybe you like to explain to the family.. "If only".. after a while, being ignorant is not blessed when there is something out there for the patients well being. EMS care should be about the patient care, not EMS personel ego's. Compare this with what ever analogy, you want to.. but everyday, every minute somewhere in U.S. someone is having an AMI.. now the treatment they receive within the first 30 minutes determines their outcome. If you do not know or recognize this, then read some medical literature.. 

You don't think the system is broken, then look at the "save rates" we have prehospital. Look at response time of BLS care and then ALS intervention. Again, "time is muscle"...  it is all nice to say we are doing a great job, if that was true.. but I doubt anyone can say they have the "best" system.. I am sure, there is room for improvement no matter where or whom you are. 

R/r 911


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## Mercy4Angels

zip, zero, zilch, nada.....far as i nkow we need medics


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## Nycxice13

As an EMT-B in NY, we can give O2, Oral-Glucose, Albuterol, Activated Charcoal, Asperine and Epi. We can assist with Nitro, I heard that we might have syrup of ipecac too, general pharacology was too long ago to remember.


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## MeaganIV

Glucagon is not in the scope for EMR's or EMT-B's in your case.  For now you gotta stick to that oral glucose.  No hormones for you.


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## Nycxice13

> As an EMT-B in NY, we can give O2, *Oral-Glucose*, Albuterol, Activated Charcoal, Asperine and Epi. We can assist with Nitro, I heard that we might have syrup of ipecac too, general pharacology was too long ago to remember.



[/QUOTE]





MeaganIV said:


> Glucagon is not in the scope for EMR's or EMT-B's in your case.  For now you gotta stick to that oral glucose.  No hormones for you.




Uhhm, were you talking to me?


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## MeaganIV

Uhhm, were you talking to me?[/QUOTE]

OH no.  I was just replying to the general subject.


Ipicac? thats been discontinued... activated charcoal is whats good.


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## Nycxice13

MeaganIV said:


> Uhhm, were you talking to me?



OH no.  I was just replying to the general subject.


Ipicac? thats been discontinued... activated charcoal is whats good.[/QUOTE]

Yea, they still told us about it in training. Dont know why though.


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## MeaganIV

Yeah thats wierd. 

Ipecac doesn't really do anything for ingested poisons... they readily cling better to the charcoal.


Activated charcoal isn't in the scope of the EMR's here.

Is it in you guy's scope?


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## Nycxice13

yep, with medical control clearance.


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## MeaganIV

Nycxice13 said:


> yep, with medical control clearance.



No kidding.  Huh.  Thats kinda cool.  Woulda been nice to have that in my scope when I was an EMR.


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## YYCmedic

MeaganIV said:


> No kidding.  Huh.  Thats kinda cool.  Woulda been nice to have that in my scope when I was an EMR.



Would have been nice to have anything more that what we got as EMR's...  Quick, someone call 911... oh wait.. .thats me.... would you like a band-aid for your tachyarrhythmia?... :wacko:


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## MeaganIV

TJ_EMT said:


> Would have been nice to have anything more that what we got as EMR's...  Quick, someone call 911... oh wait.. .thats me.... would you like a band-aid for your tachyarrhythmia?... :wacko:



hahahaha yeah no kidding eh?

Just walk in with a c-collar and an NRB... hold c-spine.. QUICK HOLD C-SPINE!! 

But he's in a diabetic coma...

.... OH GOD!!!

but now we have hormones and carbohydrates to adminster... oh yeah


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## EMS215

*jersey*

Here in jersey as basics, we can deliver NTG MDI Epi Pens O2, all under standing orders. Activated Chrcoal is frowned upon in Jersey. Except for the O2, the pt must have an RX for the med.


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## Mercy4Angels

EMS215 said:


> Here in jersey as basics, we can deliver NTG MDI Epi Pens O2, all under standing orders. Activated Chrcoal is frowned upon in Jersey. Except for the O2, the pt must have an RX for the med.



yea he is right i dont know what the heck i was thinking.


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## Ridryder911

Pablo the Pirate said:


> well i think with the proper training just about anyone can give drugs.  EMT-Bs are by no means stupid and they are highly trainable.  Remember that all *"Paragods" started out as "nothing better" than EMT-Bs.  Medics may save lives but basics save your paramedic :censored: :censored: . * It kinda sounds like some of you should remember that.  with that being said as a basic i could give 325mg ASA, Nitro that we carry, glucagon, oral glucose, O2 of course, albuterol nebs, and NS IVs all that standing orders.  with med control Activated charcol and Epipen.  and it's not really a med but we combitube also.  In my section of the US basics can do alot of skills and i think it's great. thats just my 2 cents




Okay, her we go... sorry you are grossly incorrect! Not all Paramedics started as EMT basics.. we have about 5, including myself. I went to Paramedic class without ever having my basic.. so, kinda shoots that theory down the drain. There are several thousands out there that never worked as a basic.  

Remember skills should not be confused with knowledge.. hence the difference between education and training and the title technician and practitioner. The only time I ever seen an EMT really save a medics arse, was a medic that had an AMI and he was able to shock him and call for additional ALS. EMT's save Paramedic is only a saying to sell whackers "T-shirts, belt buckles, etc.." for self ego. It should always be a team effort, and if you saved your medic arse, then you as well saved your own. Remember, both of you will be setting in the courtroom, your name will be on that report as well. 

R/r 911


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## Flight-LP

Hmmm, seems to be a trend in posts lately................


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## Mercy4Angels

he is definitly right about not having to get your basic b4 going paramedic. you can get a 4 year college degree for paramedics. you can even go to a jr. college for an associates in paramedics. why would you want to compete with the medics and save their butts? the medics are there to save yours. i always treat them with the utmost respect cause they have a higher training level than me and are there to do what i cant. ITS kind of like the SWAT team for cops. who does the police call when they need help ? SWAT !


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## jeepmedic

Most states require for you to be an EMT-B before testing for any ALS. Now I understand that some of you "old folks" were not EMT-A/B's before going to EMT-P but the first 3 letters are still EMT.  Here in Virginia even RN's that challange the EMT-I test have to pass the EMT-B test first.


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## Mercy4Angels

jeepmedic said:


> Most states require for you to be an EMT-B before testing for any ALS. Now I understand that some of you "old folks" were not EMT-A/B's before going to EMT-P but the first 3 letters are still EMT.  Here in Virginia even RN's that challange the EMT-I test have to pass the EMT-B test first.



yea each state has their own rules and regs.:wacko:


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## fyrdog

Pablo the Pirate said:


> well i think with the proper training just about anyone can give drugs.  EMT-Bs are by no means stupid and they are highly trainable.  Remember that all "Paragods" started out as "nothing better" than EMT-Bs.



You are right I did start out as an EMT so I think I can speak with knowledge of the situation. If you are so smart of an EMT why don't you go to Paramedic school if you want to administer medications? I am always suspicious of an EMT who thinks they are smarter than a paramedic. I don't think I am smarter than a doctor or a nurse. I can train a monkey to give medications but he can't learn why he is giving them or why he shouldn't. 

I am quite capable of saving my own A$$ even after I fix everything some EMT messed up. Funny I save the EMT's A$$ too.


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## Ridryder911

Again, I refer to another response I posted (this can also apply to Should Basics Intubate) 

_  Whenever you say, "I can do everything that a blank (Intermediate, Paramedic, RN, MD, etc) can except for (or but)" basically you are saying you are something that you are not.

It is a disclaimer in an attempt to garner credibility and respect. *If you want to be the something you are trying to equal yourself to, then go to school. Otherwise, don't try to convince the rest of the world that you are something that you are not.*

For example, if you are an EMT with special skills or EMT/I that can utilize 90% of the skillset of a Paramedic with only 50% of the education, who would you rather have treat you or your family?

You can train any lay person to start an I.V, intubate, decompress a chest or give any plethora of medications (training) versus teaching that person the who, what, where, when, why and how to come to the decision to do it (education).* Period* _


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## wolfwyndd

Ridryder911 said:


> You can train any lay person to start an I.V, intubate, decompress a chest or give any plethora of medications (training) versus teaching that person the who, what, where, when, why and how to come to the decision to do it (education).* Period*


I'm not sure if I can buy that.  The area I run in has very few calls.  When we have more then ONE call at a time, we have a hard time getting volunteers to show up and get the second rig out the door.  We've occassionally had residents show up on our front door several hours after a call we missed and complained to us about not showing up.  Our Chief's response is usually something along the lines of, 'become an EMT-B and you wouldn't need us.'  Usually they respond with something along the lines of, 'I can't / don't want to do that!'  The point I'm trying to make, and was made in another thread a couple of days / weeks ago, is that not everyone is cut out for this line of work.  You might be able to teach someone already in this line of work to start an IV, intubate, decompress a chest or give medications, but I don't think you can train any lay person off the street to do it.


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## Ridryder911

Sure you can "train" anyone to do anything basically. As posted in other threads how obviously "easy it is to intubate, start IV's, etc" true the mechanism and skill is easy enough, heck even surgery is easy, I have snipped (cauterized) out appendixes, but actually having the knowledge behind the theory, knowledge of risks, all of the anatomy/pathophysiology behind the procedure as well as "potential" risks and treatment associated with this is why there are license and certifications. Unfortunately, EMS always wants to take short cuts in education and health care. That is why EMS in most health care realms is not really considered a "health care agency" rather a public service. 

It goes back again back to the intent and interest in the person performing the procedure. As well the interest in that person to either get formal education or attend a CEU to just to get "trained" in it.  Can these personnel be able to handle the situation when the "poop" hits the fan, when that simplistic procedure turns bad? What happens when that Basic intubates to only have that patient have a laryngospasm, or the cords has a chordial tumor ? Then, after wards whom is going to place the patient on the ventilator? 

Shame on your Chief to be such an idiot! The first time my family had called for EMS and they were not aware of a "response" needed and had delay of several hours, you could name your town after my family member... volunteer or not!  There is no justification or excuse for such blunt * gross negligence! * Does your town have an city attorney ? I wonder if they are aware of this? .. I bet not! Does he know there is legal implications by not responding.. remind him of the first rule in negligence is a * Duty to Act *. 

If you can not offer the service then get the hell out of it.....no EMS is better than a half arse one. Scrap the existing one and at least start one that will actually respond. Has anyone made contact with neighboring communities for mutual aid ? I can see a long response in scarce remote mountainous area, plains, and yes very very remote areas, but hours before they were responded to? 

More and more I explore U.S. EMS the more scarier it is!

If any of those family members want some extra cash, have them I.M. me, I'll be glad to testify against your Chief and service.

R/r 911


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## jeepmedic

OK if you don't like it get out.


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## ffemt8978

wolfwyndd said:


> The point I'm trying to make, and was made in another thread a couple of days / weeks ago, is that not everyone is cut out for this line of work.  You might be able to teach someone already in this line of work to start an IV, intubate, decompress a chest or give medications, but I don't think you can train any lay person off the street to do it.



You can teach anybody how to perform the mechanical skills necessary to do any of these procedures...


What you can't teach everyone is the knowledge of when to do them, why to do them, and most importantly, when NOT to do them.  We've all seen the people with a new skill set so anxious to use them that they forget the basics of patient care (starting an IV before obtaining baseline vitals, etc...)

I believe that this is the education point that RidRyder is trying to make.


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## Ridryder911

Thanks FFEMT8978, exactly my point. 

Can one imagine going to a hospital to be treated by respiratory technicians that was administering you breathing treatments only to find out that they were only taught on how to turn the machine on, place med.'s in the nebulizer and be sure the patient kept the mouth piece in mouth. You would call foul! In fact for years, that is exactly what happened until R.T.'s recognized the need for improving their profession as well. From CEU's to mandated educational courses involving testing and clinical experience and requiring formal education has now changed the patient's outcome as well as their profession and pay. Can you imagine a pharmacy technician being solely responsible for filling your prescription..? How, hard can it be to pour "pills" in a bottle ? 

I still do not understand any argument against education.... It would appear to me EMS would want more and more in-depth; not just for their sake but their patients sake as well. Obviously what we are doing is not working. 

How can anyone argue about increasing the level of knowledge.? Is it better to remain ignorant or stupid, than to have knowledge in the profession you perform in ? Surely, our patients deserve better. 

Working in a diverse health care setting, I have only found EMS to be antagonist in mandating stricter and more in-depth educational requirements, where as other health care providers boast about their educational standards and the growth by doing so.

I and many other educators have fought against ignorance and realize the need for  things to change. Shame so many have to suffer in the mean time...

Our job and profession is an important one, and each member of it albeit paid or volunteer has an obligation to each patient to deliver the best care available (which includes knowledge and skills). 

R/r 911


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## trauma1534

Ridryder911 said:


> Thanks FFEMT8978, exactly my point.
> 
> Can one imagine going to a hospital to be treated by respiratory technicians that was administering you breathing treatments only to find out that they were only taught on how to turn the machine on, place med.'s in the nebulizer and be sure the patient kept the mouth piece in mouth. You would call foul! In fact for years, that is exactly what happened until R.T.'s recognized the need for improving their profession as well. From CEU's to mandated educational courses involving testing and clinical experience and requiring formal education has now changed the patient's outcome as well as their profession and pay. Can you imagine a pharmacy technician being solely responsible for filling your prescription..? How, hard can it be to pour "pills" in a bottle ?
> 
> I still do not understand any argument against education.... It would appear to me EMS would want more and more in-depth; not just for their sake but their patients sake as well. Obviously what we are doing is not working.
> 
> How can anyone argue about increasing the level of knowledge.? Is it better to remain ignorant or stupid, than to have knowledge in the profession you perform in ? Surely, our patients deserve better.
> 
> Working in a diverse health care setting, I have only found EMS to be antagonist in mandating stricter and more in-depth educational requirements, where as other health care providers boast about their educational standards and the growth by doing so.
> 
> I and many other educators have fought against ignorance and realize the need for  things to change. Shame so many have to suffer in the mean time...
> 
> Our job and profession is an important one, and each member of it albeit paid or volunteer has an obligation to each patient to deliver the best care available (which includes knowledge and skills).
> 
> R/r 911



I wish you would just stop bashing those of lower certification level than you.  I think everyone is well aware of your belief on training verses education.  I just don't understand why you are still in EMS or even in the forum if you don't respect those in the field.  We all from Paramedic down have put in alot of blood sweat and tears into our training.  

While we are discussing education... listen to this.  It takes Virginia Trained Paramedics approx 6 years to get through all the school before becoming a paramedic if they go streight through and up through the ranks as suggested.  In order to take an ALS class in this state, you are suggested to be an EMT-B for a min of one year.  To move forward to each level, it is suggested that you stay at each level for one year prior to moving up.  No, not all do it that way.  However, if you do it like you are suggested, you get more "education" verses training and you don't come out a "cook-book" medic,  you come out a compitent critical thinking provider.  

So, Virginia has a very good education system for EMS if people would follow the suggested path.  I don't have respect for anyone other than one person I know who went from 0-hero in 2 years... and that person is Prizenmedic.  He is a rare type of provider.  Everyone else I have ever met who were like that and skipped ranks, were no good to anyone in the back of the truck, and just down right dangerous!!!  So... in a since, I am with you Ridryder on the Education part being important.  However, if you just don't like the EMS system, the only thing I can suggest to you is to stop complaining about it and get out of it.  I'm sure that you could do much more and make more money as a Nurse Practioner.


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## wolfwyndd

Ridryder911 said:


> Shame on your Chief to be such an idiot! The first time my family had called for EMS and they were not aware of a "response" needed and had delay of several hours, you could name your town after my family member... volunteer or not!  There is no justification or excuse for such blunt * gross negligence! * Does your town have an city attorney ? I wonder if they are aware of this? .. I bet not! Does he know there is legal implications by not responding.. remind him of the first rule in negligence is a * Duty to Act *.
> 
> If you can not offer the service then get the hell out of it.....no EMS is better than a half arse one. Scrap the existing one and at least start one that will actually respond. Has anyone made contact with neighboring communities for mutual aid ? I can see a long response in scarce remote mountainous area, plains, and yes very very remote areas, but hours before they were responded to?
> 
> More and more I explore U.S. EMS the more scarier it is!
> 
> If any of those family members want some extra cash, have them I.M. me, I'll be glad to testify against your Chief and service.
> 
> R/r 911


I DEFINATELY will not argue your point here.  In fact, I agree with you 150 percent.  Unfortunately, our chief has managed to create a nice little dictatorship in the Squad.  Sue does no good either.  I, personally, know of 5 (five) lawsuits against our Squad and somehow the Squad has managed to either beat them or settle out of court.  If you're interested in sueing our Squad, you're going to have to stand in line behind my wife.  She's an attorney and has been DYING to file a lawsuit.  At the momment, the only thing stopping her is the fact that I still run there and it would make life :censored: for me.  I'm working on getting on one of our neighboring squads so I can get the :censored: out of there.  
Minor clarification though.  The squad KNEW there was a call, but we had no crew on duty to respond to the call that was missed.  The first out crew was on another call and we had no second crew to respond.  By the time it actually went to mutual aid (10 minutes) the family that called originally called back 911 and said forget it, they'd go to the hospital themselves.


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## Ridryder911

trauma1534 said:


> I wish you would just stop bashing those of lower certification level than you.  I think everyone is well aware of your belief on training verses education.  I just don't understand why you are still in EMS or even in the forum if you don't respect those in the field.  We all from Paramedic down have put in alot of blood sweat and tears into our training.
> 
> While we are discussing education... listen to this.  It takes Virginia Trained Paramedics approx 6 years to get through all the school before becoming a paramedic if they go streight through and up through the ranks as suggested.  In order to take an ALS class in this state, you are suggested to be an EMT-B for a min of one year.  To move forward to each level, it is suggested that you stay at each level for one year prior to moving up.  No, not all do it that way.  However, if you do it like you are suggested, you get more "education" verses training and you don't come out a "cook-book" medic,  you come out a compitent critical thinking provider.
> 
> So, Virginia has a very good education system for EMS if people would follow the suggested path.  I don't have respect for anyone other than one person I know who went from 0-hero in 2 years... and that person is Prizenmedic.  He is a rare type of provider.  Everyone else I have ever met who were like that and skipped ranks, were no good to anyone in the back of the truck, and just down right dangerous!!!  So... in a since, I am with you Ridryder on the Education part being important.  However, if you just don't like the EMS system, the only thing I can suggest to you is to stop complaining about it and get out of it.  I'm sure that you could do much more and make more money as a Nurse Practioner.



I recommend reading without emotion. I was talking and discussing all  levels generically. I am as dissapointed with the way Paramedic training has went as well.

No, I am not leaving EMS. In fact, I am personally getting more and more involved in EMS infrastructures. I have found out with the higher education levels, my suggestions are being listened to more than ever since I have more credibility. It is just unusual a professional educator and EMS activist to participate in EMT forums. 

How many NHSTA, State EMS Directors, NREMT Board of Directors, EMS Medical Directors does one see participate in EMS forums ? Or for that goes, how many professional medics participate in EMS forums in comparison to the millions working in the field ? 

Many of those professionals regards EMS forums as "feel good for egos" and "swapping war stories" sites, maybe the most viewed topic of being "what boot should I wear?". I personally view forums as an avenue to be able for us in EMS to be able to increase awareness of EMS Systems, current and proposed changes within the system, be able to learn of of other EMS systems nationally and internationally, as well as to be able to vent feelings for comradely support. Hopefully we can increase our knowledge in new and recent patient care topics, and of course tell jokes. But the main purpose is to I would hope would be to "to develop friends". Which I personally have accomplished from this site. 

It was from EMS forums an organization was formed that has no gained respectability & credibility have been able to make suggestions to national and state steering committees for changes within EMS. Some of are members from this very forum. I can assure you many of these participants did not always agree with each other, with some topics became  very heated & controversial. But, we all agreed upon one thing each wanted EMS to be a better system. In fact the more heated debates the more and more members started participating in and the forums increased their membership. 

I believe you, that you think Virginia has an outstanding EMS system, I have heard quite the opposite of that. Personally, I do not know. I am sure it is like every other state, it has its' good and bad. Communicating and discussing with fellow co-workers is great but learning outside the "box" also means learning broadening ones' horizon and learning of other systems albeit local, state or even internationally. I know I have from many of you. 


Respectfully,
R/r 911


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## Airwaygoddess

Country Medical Director, State EMS Office determines scope of practice for all EMT-B's EMT-I's and EMT-P's  The bottom line, we are here by choice to do the job that we do.  It is the patients that are depending on us.


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## Airwaygoddess

P.S.  I hate worms!:wacko:


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## trauma1534

Ridryder911 said:


> I recommend reading without emotion. I was talking and discussing all  levels generically. I am as dissapointed with the way Paramedic training has went as well.
> 
> No, I am not leaving EMS. In fact, I am personally getting more and more involved in EMS infrastructures. I have found out with the higher education levels, my suggestions are being listened to more than ever since I have more credibility. It is just unusual a professional educator and EMS activist to participate in EMT forums.
> 
> How many NHSTA, State EMS Directors, NREMT Board of Directors, EMS Medical Directors does one see participate in EMS forums ? Or for that goes, how many professional medics participate in EMS forums in comparison to the millions working in the field ?
> 
> Many of those professionals regards EMS forums as "feel good for egos" and "swapping war stories" sites, maybe the most viewed topic of being "what boot should I wear?". I personally view forums as an avenue to be able for us in EMS to be able to increase awareness of EMS Systems, current and proposed changes within the system, be able to learn of of other EMS systems nationally and internationally, as well as to be able to vent feelings for comradely support. Hopefully we can increase our knowledge in new and recent patient care topics, and of course tell jokes. But the main purpose is to I would hope would be to "to develop friends". Which I personally have accomplished from this site.
> 
> It was from EMS forums an organization was formed that has no gained respectability & credibility have been able to make suggestions to national and state steering committees for changes within EMS. Some of are members from this very forum. I can assure you many of these participants did not always agree with each other, with some topics became  very heated & controversial. But, we all agreed upon one thing each wanted EMS to be a better system. In fact the more heated debates the more and more members started participating in and the forums increased their membership.
> 
> I believe you, that you think Virginia has an outstanding EMS system, I have heard quite the opposite of that. Personally, I do not know. I am sure it is like every other state, it has its' good and bad. Communicating and discussing with fellow co-workers is great but learning outside the "box" also means learning broadening ones' horizon and learning of other systems albeit local, state or even internationally. I know I have from many of you.
> 
> 
> Respectfully,
> R/r 911



You would be greater respected if you would stop bashing people, and trying to talk down.  Heck, you even use dialog as if you were writing a text book instead of talking to us as people.  

As far as Virginia having a good EMS system, I think it could stand improvement, just like all states.  If you don't know how it is here, you should keep your speculations to yourself.


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## Guardian

I honestly don't believe he is trying to "talk down" to anyone.  We're very lucky a man of his experience and education is taking time out of his schedule to post on here.  Lets all agree to stop with the personal attacks, please.


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## Basermedic159

Acetaminophen
Activated Charcoal
Albuterol
Aspirin
Atropine
Diphenhydramine
Epinephrine
Glucose
Ibuprofen
Naloxone
Nasal Spray
Nitroglycerin
Oxygen
Pralidoxime

These are the medications I can prescribe as an EMT-B in the State Of North Carolina


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## medic417

Glad to see someone figured out the search feature.  I do ask if you actually write prescriptions or do you just administer what the medical director has ordered?


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## fortsmithman

Epi-do said:


> Here we can do oxygen, ASA, oral glucose, NTG, epi-pens, and albuterol inhalers.  The last three we can only "assist" with and the patient must already have the medication.



Thats what our EMRs here in the nwt can do.


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## JPINFV

Basermedic159 said:


> These are the medications I can prescribe as an EMT-B in the State Of North Carolina



Prescribe?


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## Veneficus

JPINFV said:


> Prescribe?



Prescribe, administer, only a small difference 

But really, this thread is from 2006!

Talk about a day late and a dollar short.


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## JPINFV

Veneficus said:


> Prescribe, administer, only a small difference
> 
> But really, this thread is from 2006!
> 
> Talk about a day late and a dollar short.




Would you rather he starts a new thread? A militant thread? If so, just name the system!


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## Veneficus

JPINFV said:


> Would you rather he starts a new thread? A militant thread? If so, just name the system!



Starwars sexual harassment?

I find your choice of pictures...

Disturbing.


----------



## JPINFV

Veneficus said:


> Starwars sexual harassment?
> 
> I find your choice of pictures...
> 
> Disturbing.


In my defense, I'm too lazy to rehost the image, and it was the first non-huge image of Grand Moff Tarkin I could find. It's also from the Star Wars wiki site. 

http://starwars.wikia.com/wiki/Wilhuff_Tarkin#Destroyer_of_worlds


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## Basermedic159

Yes prescribe as in administer. Any time you administer a medication, you are prescribing it. However you are under a physicians medical license. 

@ Veneficus- The post may be from 2006, but you commented in it... Who's a day late now?


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## WuLabsWuTecH

per protocols:


Pt Assisted:
MDI
Nitro
Epi-Pen

Always available off the truck (available on standing orders):
ASA
Charcoal
O2
Oral Glucose
Mark I kits

Need Online Medical Control to take off the truck:
EpiPen
Epinephrine Sub-Q: allergic reaction only (this is very rare that a protocol allows for this but it is in the state training and EMS Codes)
Nitro (usually spray only)
Any MDI (most places don't carry these)
Albuterol, nebulized (becoming more common)
Technically: any over the counter medication that does not have to be on a pharmacy license; but these are rarely used and usually only carried on special duty such as event standby when carrying tylenol, neosporin and sunscreen is to our direct benefit.


----------

