Biggest problem at the EMT(BLS) Level?

[Carlos Danger]

I was actually thinking more along the lines of narcotics, not airway management. As I said that's probably a throwback to when there weren't any good SGA's around and the thinking was along the lines of "well, the patient's already dead, so where's the harm?" Ignoring that even in dead people improper intubation attempts can be harmful. Best intentions don't always work out for the best...

And I'm one of the people that thinks that paramedics as a group suck at intubation because we don't get enough education and practice at it.

Yeah, narcs are another animal. Probably very little chance of harm from a conservative dosing protocol, especially if the agonist/antagonists like butorphanol or nalbuphine are used. And there's always nitrous....

 

[TheLocalMedic]

Yeah, narcs are another animal. Probably very little chance of harm from a conservative dosing protocol, especially if the agonist/antagonists like butorphanol or nalbuphine are used. And there's always nitrous....

I have a hard time believing that any medical director would be comfortable letting basics give out any form of narcotic. Waaaayyyyy too much liability for the amount of schooling basics have.

 

[Carlos Danger]

I have a hard time believing that any medical director would be comfortable letting basics give out any form of narcotic. Waaaayyyyy too much liability for the amount of schooling basics have.

Don't get me wrong, I'm not a big fan of basics giving them without education and a solid, reasonable protocol to follow, but I can envision unusual scenarios in remote or austere settings where it may be deemed appropriate for BLS to administer opioids. Opioids are generally safe and forgiving meds, as long as you aren't using really large doses or giving them concomitantly with benzos or other sedatives.

I have a different view of what BLS should / can be than most do. I think about what the really important and effective prehospital interventions are, like epi pens, defibrillation, IM seizure meds, SGA's, etc, maybe even opioids in some cases, and I don't see much that is outside of the scope of basics. With some better education I don't see why basics can't do all those things and therefore be able to manage most prehospital situations quite well. But that's another discussion, I guess.

 

[TransportJockey]

I have a hard time believing that any medical director would be comfortable letting basics give out any form of narcotic. Waaaayyyyy too much liability for the amount of schooling basics have.

I know of at least one frontier service in Texas with basics giving toradol and Nubain. Texas has some odd systems due to sheer size

 

[TheLocalMedic]

Don't get me wrong, I'm not a big fan of basics giving them without education and a solid, reasonable protocol to follow, but I can envision unusual scenarios in remote or austere settings where it may be deemed appropriate for BLS to administer opioids. Opioids are generally safe and forgiving meds, as long as you aren't using really large doses or giving them concomitantly with benzos or other sedatives.

I have a different view of what BLS should / can be than most do. I think about what the really important and effective prehospital interventions are, like epi pens, defibrillation, IM seizure meds, SGA's, etc, maybe even opioids in some cases, and I don't see much that is outside of the scope of basics. With some better education I don't see why basics can't do all those things and therefore be able to manage most prehospital situations quite well. But that's another discussion, I guess.

That highlighted bit? Yeah, that's the problem. Basics need more education before they can do these things. Like, say, a paramedic program?

 

[Carlos Danger]

That highlighted bit? Yeah, that's the problem. Basics need more education before they can do these things. Like, say, a paramedic program?

Most of those things are currently being done by basics already.

How much education does it take to give an IM injection to a seizing patient?

 

[VFlutter]

Most of those things are currently being done by basics already.

How much education does it take to give an IM injection to a seizing patient?

Ever play lawn darts? Same difference