ALS or BLS: Antidotes?

[mycrofft]

Is anyone being given teaching, protocols and materials to give any drug or chemical (oral, parenteral, topical or inhaled) to "neutralize" a toxin?

I'll accept epicac and charcoal/sorbitol slurry PO. Let's leave NARCAN out of this (that way lies madness). What about addressing intoxications like organophosphates, household cleaning agents, etc? Toxic plants? Animal venoms?

 

[mycrofft]

That got buried fast!

 

[usalsfyre]

Atropine for organophospates is pretty standard but most units don't carry enough to do so. The same with calcium for CCB overdose and glucagon for beta blocker overdose. We have a protocol for calcium after a black widow spider bite that's long standing (and probably going away soon).

 

[MrJones]

My favorite - flumazenil for EMS-induced benzo overdose.

 

[mycrofft]

Are the atropine and flumazenil on protocol or just "knowledge"?

The calcium for latrodectus sp. bits has ben iffy for a long time.

 

[Medic Tim]

I work in an industrial/ oil field clinic. I have a variety of meds and guidelines. We are able to follow msds sheets and poison control.

I have also given narcan for an imodium od.

 

[johnrsemt]

At my old services we had protocols for Atropine for Organophospates; but like was said it took 3 trucks to get enough to do any good.
Glucagon for Beta Blocker OD's, but it takes 3mg and we only carry 1mg here.
They were all under protocols.

Here we carry Flumazenil but have to call for orders for it.

 

[usalsfyre]

Atropine is in the protocol

 

[Medic Tim]

A service I used to work for carried 5mg/ml atropine vials. Most trucks carried 40to 60 mg on top of the pre fills.

 

[NomadicMedic]

We used to carry calcium gluconate gel for hydrofloric acid exposure.

And we carry a CyanoKit for suspected cyanide poisoning.

 

[UnkiEMT]

At my old services we had protocols for Atropine for Organophospates; but like was said it took 3 trucks to get enough to do any good.

I actually do have atropine in protocol, and in fact carry enough for a few pts in antidote dosing. Since I'm almost exclusively IFT, barring an MCI, I'll never use it for poisoning...and in an MCI, since I'm stationed right behind the local hospital, my first stop would likely be there to grab a bunch from their pharmacy.

Don't carry 2-PAM, though.

 

[NomadicMedic]

We also carry a boat load of 2-Pam.

 

[Handsome Robb]

We carry multi dose atropine vials and have a protocol to use them for organophosphate poisoning however the multi dose kit has a thing on I that says "for crew members only" we have to use bristojets for patients and only carry 4 mg...

 

[JPINFV]

Atropine is in most/all of the protocols in So Cal for organophosphate poisoning. Also most of the ambulances carry a MarkII kit for the crew, not for the patients.

Also Miami-Dade Fire Rescue runs a venom response program where they have members who are trained in snake bites and stockpile anti-venom. However they respond to the local hospitals and treat there so that the hospitals don't have to stockpile anti-venom.
http://www.miamidade.gov/fire/about-special-venom.asp

 

[johnrsemt]

We carry Atropine (5mg) and have access for 50mg for transport. Also carry the new version of the MarkII kits for us and anyone that has access to poisoning has them also.. Plus we have access for transport for more 2-PAM.
Different circumstances than for normal organophosphate poisoning, but we are worried about it

 

[MrJones]

Atropine is in the protocol

As is the flumazenil usage to which I referred.

 

[Bullets]

We carry Duodote, atropine and pralidoxime chloride, for organophosphates and CyanoKit for cyanide exposure. But both are for our use only

 

[DesertMedic66]

We used to carry the Mark kits/DuoDotes in all of our ambulances. 3 doses for each crew member. However the county is no longer having us carry those in the ambulances. They will either be held by the supervisors and/or County Health Department.

We still carry the multi-dose Atropine vials. We have no max dose listed. It's just as clinically indicated.

We carry 2mg of glucagon in the ambulance and then the fire department will also have 1-2mg.

 

[usalsfyre]

mycrofft

I take it you didn't get the response of "we're all cowboys who know what's right" you were looking for?

 

[mycrofft]

I take it you didn't get the response of "we're all cowboys who know what's right" you were looking for?

No, I was just curious. Why do you ask?
I was surprised at the prevalence of organophosphate antidote protocols.
Sorry I was delayed getting back to this but I was busy on a couple other threads.