I'm a wilderness guide that bounces back and forth between the mountain west and Alaska and I'm considering getting my AEMT or paramedic status to enhance my own capabilities if something should go wrong in the backcountry and I'm curious about medications. I want to build a decent, advanced med kit with some meds like antibiotics, normal saline products, epi-pens, morphine, dextrose and some other things to handle cardio and respiratory issues as well as some trauma and diabetic meds. I guess my question is, in order to get some of these things, will an AEMT be enough to get the credentials to get any of that or even a paramedic for that matter, or do I need to be a part of an EMS crew? Thanks.
Does your employer have a medical officer? They would probably be the first person to talk to. They can prescribe an epi-pen, a broad spectrum antibiotic, zofran ODT, loperamide, acetaminophen, and written instructions on how and when to offer them to the patient for self-administration. Off the top of my head that's about all the meds I would recommend, owing both to economy and lack of training in ALS. Those meds + bandaging supplies and a couple SAM splints (you don't need much of that either, because those things are easily improvised) and you've got all you need to handle 95% of what you can realistically expect to encounter. Anything really serious like a head injury or other major trauma, seizures, chest pain or signs of stroke, etc need a medevac ASAP, no matter what training you have or how large your med kit is.
You don't need dextrose or glucagon because you won't find many brittle diabetics at risk for hypoglycemia on physically taxing outings in remote areas. On the outside chance that does occur, make them show you their glucagon kit and dextrose gel and make sure you know where it is. IV fluid is heavy and bulky and takes a lot of understanding to use safely in the settings you are describing. Oral rehydration works better than IV, anyway.
A WEMT course is really the way to go; they'll go over all this stuff and you'll get to network and learn from others who do this work. Lots of good books out there on this stuff, too.
I'd focus on learning the risks of going into a remote area to do physically taxing stuff when you are out of shape, and also how to to do a good risk assessment on an individual and how to tactfully explain risks to those who need to hear it in a way that doesn't sound like you are trying to talk them out of it, but just make sure they are well informed. A well-written medical questionnaire / release of liability for complications relating to medical condition would be a good place to start, if your employer doesn't already have one. I would imagine tools are available out there for this stuff, but if not, a physician or PA or NP who has experience in this area should be able to help you out.
