How many drugs do you carry on your rig?

[MMiz]

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"

I think it all depends. When I hurt me knee (turned out I shattered a part of my patella) I got morphine for a five minute ride to the hospital.

Jon's right about the county system. It's an all or nothing type of deal. We all use county radios, county drugs, and county backboards. Personally I think the system is broken, as there is little personal accountability, but that's a totally separate thread.

 

[Flight-LP]

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"

Sorry, but I call BS on this one. Any proficient physician can objectively examine a patient with analgesics on board. Even if they are drooling. To withhold pain medications so a physician doesn't have to actually challenge himself by actually placing his hands on a patient is cruel, unethical, and negligent. Treat the patient for the patient, not for the doctor. Hell, they make enough $$$, let them earn it!

BTW, to answer the original post, 54 meds + blood if needed.............

 

[Wingnut]

Sorry, but I call BS on this one. Any proficient physician can objectively examine a patient with analgesics on board. Even if they are drooling. To withhold pain medications so a physician doesn't have to actually challenge himself by actually placing his hands on a patient is cruel, unethical, and negligent. Treat the patient for the patient, not for the doctor. Hell, they make enough $$$, let them earn it!

BTW, to answer the original post, 54 meds + blood if needed.............

Wow blood too? We only withhold drugs on abdominal pain, but they are allowed to get nitrous, that's what I was asking about. Maybe I'll ask the medic at work tomroow.

 

[rescuecpt]

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"

Yeah, we don't get narc orders too often, but when we do its usually for cardiac problems or stat ep, not necessarily for pain.

As far as our "fancy" lock-down system, it's only for narcs, and once the safe is open the ALS provider has to carry the narcs in a fanny pack on their person, until the extras are wasted in front of the nurse who signs off the paperwork, and we reinventory the narcs and lock them back up. When we get back, we have to call our narcotics director, who either comes down to restock or puts a different rig in service as first due. NYS doesn't play around with narcs, there are only a few services in my area who carry them because the state is so strict about how to keep them locked and stuff.

It doesn't really take that long to get them out of the safe, and for us, the nearest non-flying trauma center is at best 15 minutes out, so there's plenty of time to get out the narcs.

 

[circusmidget]

just curious, not sure if reading this right, but my take on this thread is that its ok in the states to give entonox/nitrous for unDx abdo? or just Dx abdo ?

 

[Ridryder911]

It all depends on the protocols, however nitrous is very temporary and I do not see that it would hamper any differential diagnosis.

R/r 911

 

[disassociative]

On our ground rigs; there are 2 boxes; a bright red ACLS and a bright orange or yellow Narc Box. Both of these boxes are locked; and the key is carried by the senior medic. Our service doesn't have just one rig dedicated to critical care though; all busses have the same equipment. Each one goes out with either 2 Paramedics or a Paramedic with an EMT-IV or EMT-I whichever is available. Obviously when it is Paramedic and EMT-IV; the EMT-IV does the driving.
I am unsure as to the narcotics disposal protocol; as I am emt-iv and take no part in the administration or handling of narcotics. However, I am sure it is much like vandy's protocol: Nurse or physician present to sign off. Narcs are provided as needed to the service.

In the event that there is a narc count and something comes up short;
heads will roll and @$$'s will fry.

 

[Firechic]

To withhold pain medications so a physician doesn't have to actually challenge himself by actually placing his hands on a patient is cruel, unethical, and negligent. Treat the patient for the patient, not for the doctor.

I agree with you 100% on this one. My department does not withhold pain medications. Also, there have been numerous lawsuits with regard to NOT treating pain in the field.

 

[ResTech]

BLS units in PA only carry Epi in form of EPi-Pen... ALS carries alot..

1. Adenosine
2. Albuterol
3. Amiodarone
4. Aspirin
5. Atropine sulfate
6. Benzocaine--for topical use only
7. Bretylium
8. Calcium chloride
9. Dexamethasone sodium phosphate
10. Diazepam
11. Dilaudid--for interfacility transports only
12. Diltiazem
13. Diphenhydramine HCL
14. Dobutamine
15. Dopamine
16. Epinephrine HCL
17. Fentanyl
18. Furosemide
19. Glucagon
20. Heparin by intravenous drip--for interfacility transports only
21. Heparin lock flush
22. Hydrocortisone sodium succinate
23. Glycoprotein IIb/IIIa Inhibitors--for interfacility transports only
a. Abciximab
b. Eptifibatide
c. Tirofiban
24. Intravenous electrolyte solutions
a. Dextrose
b. Lactated Ringer's
c. Sodium chloride
d. Normosol
e. Potassium--for interfacility transports only
25. Ipratropium bomide
26. Isoproterenol HCL--for interfacility transports only
27. Levalbuterol--for interfacility transports only
28. Lidocaine HCL
29. Lorazepam
30. Magnesium sulfate
31. Metaproterenol
32. Methylprednisolone
33. Midazolam
34. Morphine sulfate
35. Naloxone HCL
36. Nitroglycerin by intravenous drip--for interfacility transports only
37. Nitroglycerin ointment
38. Nitroglycerin spray
39. Nitroglycerin sublingual tablets
40. Nitrous oxide
41. Oxytocin
42. Phenergan
43. Pralidoxime CL
44. Procainamide
45. Sodium bicarbonate
46. Sodium thiosulfate
47. Sterile water for injection
48. Terbutaline
49. Tetracaine--for topical use only
50. Verapamil