help with Antiemetics in California

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gymini

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Hi Guys,
I'm interested in trying to get antiemetics approved in my county. I spoke with a supervisor the other day about the approval procees; apparently it is much easier if the drug is already a Title 22 approved drug. Does anyone know where I can find the approved paramedic drugs for California, and are there any departments in California that are currently using antiemetics?

Thanks!!
 
Wow.. I cant believe California doesn't allow Paramedic admin of an antiemetic. Do they allow oxygen?
 
Antiemetic administration would be a "local optional scope" thing, and would have to be studied and/or approved by the local EMS Agency and the State EMSA would have to basically agree as well... Possible, yes, PITA, yes.
 
2 Counties out of 58 (31 EMS Systems, because some systems span multiple counties...) went as far as to administer Zofran... They went through the process. Contact them and see what they had to do in order to get that added locally... Don't re-invent the wheel...
 
I believe each county sets thier own protocol and drugs that can be administered.

Talk to your local MD/EMSA I suggest; oh if it helps we are withdrawing promethazine and giving zofran; promethazine gets you too wasted :P
 
gymini said:
Hi Guys,
I'm interested in trying to get antiemetics approved in my county. I spoke with a supervisor the other day about the approval procees; apparently it is much easier if the drug is already a Title 22 approved drug. Does anyone know where I can find the approved paramedic drugs for California, and are there any departments in California that are currently using antiemetics?

Thanks!!
Click to expand...

What County and Which EMSA?
 
MrBrown said:
I believe each county sets thier own protocol and drugs that can be administered.
Click to expand...

This is correct, to an extent. From my understanding based on what is published on California EMSA's website, a county can set the scope of practice for their paramedics up to the maximum set by state EMSA. Everything after that has to be applied for by the county and approved by state EMSA. Statute wise, paramedics have an "unlimited scope of practice," which is limited what state and county (L)EMSA. The "unlimited scope of practice" can be contrasted with the EMT-B (CA EMT-I) and EMT-I (CA EMT-II) levels where the standard and extended scopes are set by the legislature and cannot be exceeded by the medical directors except in specific cases (i.e. research).
 
California Paramedics don't have an "unlimited scope of practice", they have an "undefined scope of practice"...
 
Ahh... my mistake. Thanks for the correction.
 
As far as I know, Santa Barbara, San Diego, and ICEMA (Inland Counties Emergency Medical Agency - consists of San Bernardino, Inyo, and Mono Counties) are the only ones that carry any antiemetics (Zofran).
 
You're welcome. Unlimited = MD scope, potentially, Paramedics could function like a PA, but more supervision. Undefined = whatever EMSA/LEMSA agrees to for their local situation.

Subtle, but important distinction.
 
Akulahawk said:
You're welcome. Unlimited = MD scope, potentially, Paramedics could function like a PA, but more supervision. Undefined = whatever EMSA/LEMSA agrees to for their local situation.

Subtle, but important distinction.
Click to expand...

I'd describe physicians more as unrestricted than unlimited.
 
MrBrown said:
oh if it helps we are withdrawing promethazine and giving zofran; promethazine gets you too wasted :P
Click to expand...

I think it is better to have more than one option.
 
Don't use promethazine(Phenergan) or prochlorperazine(Compazine) if you can avoid it.

PHENERGAN has loads of side effects and can cause local necrosis, hurts later. COMPAZINE can potentiate seizures and cause teratogenicity. TIGAN (trimethobenzamide), while not cutting edge, is relatively cheap, works well and I have seen very few side effects. Can be IM or PO. Not sought as a drug of abuse.
 
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