Guideline Updates

Peak

ED/Prehospital Registered Nurse
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I do remember this, I think there were two various serious incidents in southern Colorado. It was right when I started in this area.
Myself and one of our NPs were invited to the ems case review. I thought Hurtado was going to have a stroke when the attending medic tried to tell him that he couldn't give the kid's PO hydrocortisone since it wasn't 500/800. I think you'd find more ED docs amicable to a stress dose steroid order than you would think.
 
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Tigger

Tigger

Dodges Pucks
Community Leader
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Myself and one of our NPs were invited to the ems case review. I thought Hurtado was going to have a stroke when the attending medic tried to tell him that he couldn't give the kid's PO hydrocortisone since it wasn't 500/800. I think you'd find more ED docs amicable to a stress dose steroid order than you would think.
Hurtado is actually our MD now. We have stress dose on standing order for adrenal crisis and I would not be afraid to use it as such. I think it would be tougher in a patient without a diagnosis but not responding well to vasopressors to get an order for calcium, some of the non EMS physicians are about skittish about giving orders since it so rarely happens in this system.

I believe these incidents also resulted in Chapter 2 (the state guidelines for EMS acts allowed for non CO folks) being edited to allow any EMS provider of any level to assist a patient with medications prescribed to them.
 

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