BS protocol updates

[Cake]

great. they just upgraded our BLS pharmacology to allow administration of Acetaminophen.... Tylenol!!! so now we're going to get calls for stubbed toes and hangovers. and are we really going to stay on scene for the 30 min or so for it to kick in and get results? i just dont understand the point of this. now im really starting to feel like an underpaid babysitter

 

[reaper]

Is the protocol for pain or Fever?

Liquid Tylenol is very common for pedi fevers. Sooner it is administered, the sooner the fever will start to break.

 

[WolfmanHarris]

We have a protocol for PO tylenol, benadryl and polysporin for special events. (As approved by the service.) Nothing for day to day operations.

Really though, do you think the people who call for total bull, pay attention to what's in your scope? I don't think you'll see any significant change in call volume.

 

[Cake]

we'll only have it in pill form. x2 325mg tablets for adult. no where in the protocols does it mention fever, only for pain. i wonder if we'll be using it for fevers as well...

im hoping its the case that no one will really know.. lets hope the word doesnt get out

 

[JPINFV]

Holy hell, I think this is the first time I've seen an EMT against increasing a scope of practice sans the education argument. Are you really arguing that you want to do less because doing more might increase your work load?

 

[MrBrown]

We have been dishing out panadol and leaving people at home for 30 years, great stuff, love it to bits

 

[Cake]

Holy hell, I think this is the first time I've seen an EMT against increasing a scope of practice sans the education argument. Are you really arguing that you want to do less because doing more might increase your work load?

here's my confusion- if a patient is in pain a) and its minor enough to be helped with a tylenol, why couldn't they just take one themselves being that its such a common medication? b) if its serious pain/trauma then i doubt a tylenol will matter, and its most likely going to be an ALS call where they can work with a bit more. How long does it take for tylenol to kick in? As an emergency responder, don't you think we're going for more immediate treatments?

I know I'm still new, but I feel things like tylenol and bandaids dont belong on an ambulance. These are common, available items that don't warrant the dispatch of an ambulance. It has EMERGENCY on the side for a reason.


As far as education goes, I don't think one has to be any more educated to administer tylenol than the next guy. We've been taking it ourselves since adolescents. I sure don't feel any more educated after this protocol update.

You say that I'm against increasing the scope of practice, and I see your point- baby steps baby steps- but in a way I feel that this cheapens our position even more.

 

[TransportJockey]

Never have I seen APAP in a protocol for minor pain... NM is was ONLY in the protocols for pedi fever.

 

[mycrofft]

Legalities and situations

Legalities: At least in Calif.,without an order, even in the form of a protocol, a RN cannot give oral medication. An OTC topical like ABX oint is a fencestraddler, and if there is a bad side effect (allergy?), someone can get in trouble. Where can an EMT do something a pharmacy-trained RN can't?

Situations: you are doing standby at the company picnic and someone has a headache or a muscle pain from an activity. Or they have indigestion from the rancid egg salad. They probably did not bring anything, or its been sitting in their car cooking at 135deg F for years.

The kicker for these cases is if you are doing SOAPIE documentation, you are supposed to truthfully re-asses and describe the outcome of your treatment.
Spare me.

Oh, by the way...make sure that indigestion isn't an MI or acute food poisoning, the muscle ache isn't a stree fx, and that headache isn't an incipient CVA or dehydration.

 

[TransportJockey]

Legalities: At least in Calif.,without an order, even in the form of a protocol, a RN cannot give oral medication. An OTC topical like ABX oint is a fencestraddler, and if there is a bad side effect (allergy?), someone can get in trouble. Where can an EMT do something a pharmacy-trained RN can't?

Situations: you are doing standby at the company picnic and someone has a headache or a muscle pain from an activity. Or they have indigestion from the rancid egg salad. They probably did not bring anything, or its been sitting in their car cooking at 135deg F for years.

The kicker for these cases is if you are doing SOAPIE documentation, you are supposed to truthfully re-asses and describe the outcome of your treatment.
Spare me.

Oh, by the way...make sure that indigestion isn't an MI or acute food poisoning, the muscle ache isn't a stree fx, and that headache isn't an incipient CVA or dehydration.

What do the I and the E stand for at the end of SOAP?

 

[abckidsmom]

What do the I and the E stand for at the end of SOAP?

Intervention and Evaluation

I would never call an ambulance for tylenol, but I would approach a standby unit for some. For bandaids, too.

We used to have a favorite spot to sit while we were posted where the people all played in the river, sliding on rocks in the rapids. Bandaid central!

If ERs can be used for tylenol, so can ambulances.

 

[Cake]

Intervention and Evaluation

I would never call an ambulance for tylenol, but I would approach a standby unit for some. For bandaids, too.

We used to have a favorite spot to sit while we were posted where the people all played in the river, sliding on rocks in the rapids. Bandaid central!

If ERs can be used for tylenol, so can ambulances.

As a standby unit, or working events then it makes a lot of sense, and I think its a worthy idea.

I was thinking more towards the emergency response side of things. Lets give this guy a tylenol for his amputated leg?? <_<

 

[abckidsmom]

As a standby unit, or working events then it makes a lot of sense, and I think its a worthy idea.

I was thinking more towards the emergency response side of things. Lets give this guy a tylenol for his amputated leg?? <_<

It's within the scope. I don't think I'd give anybody anything PO who was headed for the OR.

Tylenol for fever is a good tool to have in the box. Cheap, low-risk, and effective.

 

[Veneficus]

It is humane to give tylenol after a nitro if you are not administering ASA with it.

Don't use a cannon to kill a mosquito. If a patient has mild pain and tylenol will do, why start an IV or inject somebody with something?

Tylenol works really well for fever. (I like ibuprofin for kids better though)

Not to mention once you have given morphine for break through you can use an nsaid for maintenence.

Lets not forget, if you are a basic, what other pain options do you even have? Better to do something than nothing right?

 

[octoparrot]

to the OP, what state is this in? I'm curious to read up on it.

 

[mgr22]

I know I'm still new, but I feel things like tylenol and bandaids dont belong on an ambulance. These are common, available items that don't warrant the dispatch of an ambulance. It has EMERGENCY on the side for a reason.

As far as education goes, I don't think one has to be any more educated to administer tylenol than the next guy. We've been taking it ourselves since adolescents. I sure don't feel any more educated after this protocol update.

You say that I'm against increasing the scope of practice, and I see your point- baby steps baby steps- but in a way I feel that this cheapens our position even more.

Did they cover how toxic Tylenol can be, and how often people OD on it? If so, how much of that did you already know? Just because a drug is available OTC, it doesn't mean it's benign. As a healthcare provider, you've got a higher level of responsibility when you start handing out meds.

I think we "cheapen our position" when we apply our own definitions of emergencies to everyone else.

 

[lampnyter]

wow thats almost lucky, here EMTs cant even give aspirin. all we can do is glucose, epipen, activated charcoal and nitro, thats it...

 

[TransportJockey]

wow thats almost lucky, here EMTs cant even give aspirin. all we can do is glucose, epipen, activated charcoal and nitro, thats it...

CAn't give ASA but can give NTG? I'm hoping you can't just hand it out to whomever you want to

EDIT: Exactly what Lights said. As an EMT-B in NM I was expected to have the 324mg of ASA on board before a medic unit arrived (if I wasn't riding with one or an intermediate) and if they had NTG they got some of that before too.

 

[lightsandsirens5]

wow thats almost lucky, here EMTs cant even give aspirin. all we can do is glucose, epipen, activated charcoal and nitro, thats it...

What the h***? NTG but no ASA? Even as an I85 in WA, I'm supposed to give ASA before NTG, assuming ASA is not contraindicated. That just makes sense. Suspected MI/possible cardiac chest pain; "You allergic to this? No?" 325 mg chweable ASA. (well, actually 324 mg, but I won't get into that. 81x4=324. Lol)

What state are you in?

 

[lampnyter]

i dont like to give out that information but yes, we can give NTG but not aspirin.

EDIT: and no, they have to have their own nitro