ASA...cheweable vs pill

[Shishkabob]

That's what I'm saying... I'm not against EMTs giving it if ALS is a bit away as the patient would have /already has. Yes, there's a risk of an RVI bottoming out, but besides those being rare, and bottoming out being rarer, the potential good with a LVI is something that is wanted.

 

[jjesusfreak01]

You dont have these problems if you run an all ALS ambulance system...

 

[CAOX3]

You dint have these problems if you run an all ALS ambulance system...

No because patients with chest pain never empty a bottle of nitro before they call 911 in ALS systems.

The doctor prescribed the nitro for chest pain their just following orders who actually administers it is irrelevant.

And good idea, lets take this discussion down that road....:wacko:

 

[medic417]

You dont have these problems if you run an all ALS ambulance system...

I am with you there. Every patient deserves an assessment by a Paramedic. Then if the dispatcher screws up thinking BS it doesn't matter because the ambulance she sent has Paramedics. But we can't live in the dream world. The politicians will always convince the public they are safe and then use the cheapest way possible which is basics on ambulances.

 

[reidnez]

You dont have these problems if you run an all ALS ambulance system...

Better yet, go to the German system which puts a physician on every ALS rig...it's an awesome standard of care, I'm sure, but I don't think anyone in the states is going to pony up the cash for that kind of system (unless we can convince enough doctors to work for $30k/yr.) :unsure:

 

[WolfmanHarris]

(unless we can convince enough doctors to work for $30k/yr.) :unsure:

EMS isn't underpaid everywhere. I make $70k/yr base, plus excellent benefits and pension based on a 42hr work week. (4 on, 4 off, 6 on, 4 off, 4 on, 6 off). Sure cost of living makes comparison hard, but I am able to live comfortably and support a family on that pay.

It is possible with education.

Whoops. Threadjack. Sorry.

 

[atticrat]

So your requesting EMTs withold ASA in a time sensitive complaint such as MI?

Why would we do that?

From my post I said "If you can possibly wait", meaning ALS is within 1-3 minutes, not "Wait forever till the medics arrive". Should have been more specific.

Yes that's what I'm saying. ASA may not change the 12 lead, but a FULL assessment before meds. is never a bad idea.

 

[atticrat]

ASA isn't going to change your 12-lead in any way I know of .
Maybe. Our cath lab docs. expect a 12 lead before any interventions by us. If we give a med before a full assessment, they want to know why. You already know a 12 lead dosen't take that long anyway, you can snap one while you partner gets the history. Maybe your system is set up differently.




Patients give it to themselves all the time without doing their own in-home 12-lead.

Of course they do. But why would you be giving ASA to someone who's used their prescribed nitro? Because something is "different" this time, is usually the answer. Why did they call the ambulance this time? Because something is "different". You can't control what happens before your arrival, but don't you want to do full diagnostics before you go any further with this patient?

 

[Smash]

They need to chew it so it gets into system quicker. They can chew adult aspirin but tastes nasty.

Oh and aspirin is not first drug oxygen is.

Would have to respectfully disagree. Aspirin has a clear and well established benefit in reducing mortality and morbidity in ACS. Oxygen does not have such evidence and there is some suggestion (although evidence is at best sketchy) that it may cause harm. Unless the patient is distressed, hypoxemic or has that 'oh carp I'm going to die' look about them I often hold off on the O2 to help me get a better history without having strain to hear the patient.

EMS isn't underpaid everywhere. I make $70k/yr base, plus excellent benefits and pension based on a 42hr work week. (4 on, 4 off, 6 on, 4 off, 4 on, 6 off). Sure cost of living makes comparison hard, but I am able to live comfortably and support a family on that pay.

It is possible with education.

That'll never catch on!

 

[jjesusfreak01]

No because patients with chest pain never empty a bottle of nitro before they call 911 in ALS systems.

The doctor prescribed the nitro for chest pain their just following orders who actually administers it is irrelevant.

And good idea, lets take this discussion down that road....:wacko:

I would expect that a patient with nitro on them probably would have taken it if they could, but my point is really that on an ALS rig you can do a 12-lead before administering nitro, if you wish.

 

[clibb]

Better yet, go to the German system which puts a physician on every ALS rig...it's an awesome standard of care, I'm sure, but I don't think anyone in the states is going to pony up the cash for that kind of system (unless we can convince enough doctors to work for $30k/yr.) :unsure:

Those doctors do not work for $30k/yr. They make a lot more. I'd say somewhere between $70,000- $150,000. Which is a TON of money there.