How many drugs do you carry on your rig?

[Wingnut]

I found out we carry 33. And we actually carry dilaudid as well as morphine which kind of suprised me. Especially since we keep our rigs unlocked unless we're at a store. We have nitrous too but we only use it for abdominal pain because our MD doesn't want them getting the other two due to thier half life.

From EMT school I really thought we would primarily carry cardiac meds and MAYBE a handful of others.

 

[disassociative]

...

Ya know, I've never really counted; I know we keep Morphine/Dilaudid on the rigs too; ACLS drugs are usually kept in a bright yellow lockbox. Of course with lifeflight; they are everwhere, but there is one rule on lifeflight; If a paramedic doesn't tell you to, don't touch it. Maybe when I get my -P I will take a count; however at this point in time, I wouldn't want one of the flight physicians walking out to find me(an emt-iv) with liquid morphine in my hand .

 

[MMiz]

Just one... love.

And EPI.

 

[Jon]

I don't know #'s on the ALS rigs.. the county has a long approved list, but not every service carries everything.

As for MSo4 vs. Dilauid - does Dilaudid have the same effect the cardiac workload that Morphine has? Dilaudid is a "better" narcotic opioid, but Morphine is still the "gold standard"

Nitrous - I would be giving it to everyone - it has few contra-indications and is easly-applied, and a near-instant half-life.... perfect painkiller.

 

[emt4life]

We carry 27 with O2, including 2 forms of NTG (spray and bottles for drips). I wish we carried nitrous, but it is hard to get it refilled out where I work.

Dilaudid doesn't have the same the same effect as morphine for cardiac issues, it is used for pain control in those patients who are allergic to morphine. It is significantly stronger than morphine, so if you look at the bottle there is a lot fewer mg per bottle than morphine.

Does anyone carry etomidate? We were just told my our medical director to pull it because they found it may be causing renal complications. Has anyone else heard that?

 

[Ridryder911]

Etomidate can cause renal problems at a high dosage, and prolonged use. He/She might want to re-review the literature and studies of it. For a short one time use such as RSI, I have not seen or heard of any asociated renal problems. It is a great medication, we carry it and most of the flight services I know carry it as well.

R/r 911

 

[maksim]

Yeah, morphine the gold standard.
Our usual set:
Морфин 1
Omnopon (syn. Pantopon) 1.
Promedol (trimepiredine) 2.
Phentanyle (Sentonyle) 2.

N2O from the abdominal pain.
Etomidate or ketamine for a long time are not used.

 

[Anomalous]

Never thought to count. 19 ILS including oxygen.

 

[Wingnut]

Now the abdominal pain and using Nitrous, I know it's used because the half life is so short, but is that because an abdominal pain pt is more likely to have surgery or because there is a high chance they have internal bleeding? I kind of understand why they'd want that on those kind of symptoms but I don't know the actual reasoning.


Also I've seen that our medics almost never use the nitrous. They REALLY hate using it.

 

[maksim]

Also I've seen that our medics almost never use the nitrous. They REALLY hate using it.

Our too.....

 

[rescuecpt]

I found out we carry 33. And we actually carry dilaudid as well as morphine which kind of suprised me. Especially since we keep our rigs unlocked unless we're at a store. We have nitrous too but we only use it for abdominal pain because our MD doesn't want them getting the other two due to thier half life.

From EMT school I really thought we would primarily carry cardiac meds and MAYBE a handful of others.

Is the dilaudid and morphine locked up? Our morphine, atevan, and diazepam are all locked in a safe on the rig that you need a magnetic key and a personal pin to get into. If yours isn't locked up, PM me and I'll send you my address...

By the way, if you've never had morphine IV, it is very nice. hehehe.

 

[Jon]

Is the dilaudid and morphine locked up? Our morphine, atevan, and diazepam are all locked in a safe on the rig that you need a magnetic key and a personal pin to get into. If yours isn't locked up, PM me and I'll send you my address...

By the way, if you've never had morphine IV, it is very nice. hehehe.

Magnetic key?


High tech!

 

[rescuecpt]

Magnetic key?


High tech!

Yeah, you have to spin the dial a couple times to turn the safe on (it generates electricity from the spin), then you have to put YOUR magnetic key up to the reader, spin some more one way, then the other, enter your pin, spin-spin-spin, and viola! drugs!

 

[emtd29]

NO narcs on our bus.

 

[emtd29]

Yeah, you have to spin the dial a couple times to turn the safe on (it generates electricity from the spin), then you have to put YOUR magnetic key up to the reader, spin some more one way, then the other, enter your pin, spin-spin-spin, and viola! drugs!

wow. seems like a lot of work to get at your meds when you need them...

No Narcotics or other controlled substances on our rigs.

 

[Wingnut]

Is the dilaudid and morphine locked up? Our morphine, atevan, and diazepam are all locked in a safe on the rig that you need a magnetic key and a personal pin to get into. If yours isn't locked up, PM me and I'll send you my address...

By the way, if you've never had morphine IV, it is very nice. hehehe.

Yeah they are, but there just in a drawer with a regular key on the rig. Nothing fancy like your set up, hell it'd almost have to be a long *** transport to be worth getting them out.

And I know IV morphine and dilaudid are nice

 

[Jon]

Yeah, you have to spin the dial a couple times to turn the safe on (it generates electricity from the spin), then you have to put YOUR magnetic key up to the reader, spin some more one way, then the other, enter your pin, spin-spin-spin, and viola! drugs!

I like this idea, but it has to cost a LOAD of money.

At work, the narcs are sealed in a bag, the bag is accountable shift to shift, and the bag is usually stored in a locked cabinet in the rig (regular key). sometimes, at least at events, the medics will carry the narcs on their person or the ALS Bag... keeping them with the crew.

 

[MMiz]

Around here narcs are stored with the other "big" drugs in a county tackle box that is secured with a plastic tie. When we use any drugs out of the box we turn it into hospital security and they give us a new box. They're stored in a locked cabinet in the ambulance.

We used to keep the drug boxes outside stored in the locked ambulances, but then someone started to pry the doors off of the ambulances. Now they're turned in at the end of every shift and locked in the storage cage.

 

[Jon]

Nice... Bucks County PA uses a similar system.

I think the Narcs are seperate... and are swapped with the ED staff after they've been used.

The main drug box stays in a cabinet in the rig, and most services just re-stock their ALS bag out of it (County lets services use whatever they want as a jump bag, but drug exchange is through the county box). After use, the box gets exchanged with a sealed one out of a hospital pharmacy.

The system seems to work for them... but will only work if ALL services and ED's in the county are on-board.

 

[daemonicusxx]

they dont want you using morphine or any other narcotic analgesic due to the fact that the patient is going to have to answer the doctors questions about symptoms of the pain when they get to the ED. they want the patient clear headed when you get them there. dont want them sayin "well, doesnt hurt anymore after that shot the ambulance driver gave me"