Is suggesting medication allowed?

Starbase89

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I know as a Basic I am not allowed to give medication (aside from very few specified.) If I were to find a kid having an allergic reaction, would it be wrong/out of scope of practice to say "you might want to give him/her some Benadryl." Is that equivalent to giving medication in the eyes of the law?
 

MCGLYNN_EMTP

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If they are having a true allergic reaction that is worth treating such as anaphylactic patients....Your best thing to suggest is "you might want to call 9-1-1" or you might want to bring them to the hospital....Benadryl will help but the best thing to counter it would be if the patient had their own Epi-pen or if someone could give the patient epi subQ or IV a higher dose of benadryl than that parrent could probably give the kid...if the reaction has bronchoconstricion / spasm associated a neb treatment could help and solu-medrol wouldnt hurt either...but you need a paramedic or the ER for this to happen so......
The best actions IMO would be...
see if they have an epi-pen for the kid and have them administer it if availlable and have them call 911 for an ambulance..

as for the laws on that....I'm not quite sure...im just an ambulance driver :p
 

Lifeguards For Life

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I know as a Basic I am not allowed to give medication (aside from very few specified.) If I were to find a kid having an allergic reaction, would it be wrong/out of scope of practice to say "you might want to give him/her some Benadryl." Is that equivalent to giving medication in the eyes of the law?

If that is the standard of care in your area. while in all reality some benadryl probably would not hurt, if the parent had already given it to him. If a child is having an allergic reaction, and the parent deems it serious enough to call 911 the child needs to be taken to be evaluated by a physician, as you can not properly anticipate complications of the allergic reaction within the next hour, or even within the next couple minutes.
As far as the parent giving benadryl, they would have to give it enterally, which is not absorbed by the body fast enough. even administering diphenhydramine intra muscularly has an onset of 15-30 minutes.
Worst case scenario if you were to "prescribe" benadryl and this scenario were to end up in court, i think most courts would find this is not the normal response of someone of equal training and ability.
 

Summit

Critical Crazy
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Off duty you can give whatever good advice you want as long as you don't identify yourself as a medical authority.

And people can sue you for WHATEVER they want.
 

Akulahawk

EMT-P/ED RN
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Sometimes if you remember to ask the patient if they have an Epi-pen... they might remember that they have it and self-medicate...

That might be all that is needed... do you have medication that you take when this happens? Have you taken it? Where is it?

That kind of thing. Now if it's something new... you're not asking about existing meds... you're suggesting... which may be taken as you prescribing something...

Treacherous ground you walk on... Lawsuits can be plenty, for any reason. Careful, you must be...


(Dagnabbit... I just channeled Yoda... :p )
 

MCGLYNN_EMTP

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Yeah I agree...Just ask if they have medication that they take when this occurs... but these days...you can get sued for ANYTHING and EVERYTHING.
 

SurgeWSE

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you can get sued for ANYTHING and EVERYTHING.

This is key. If you avoid everything in life that someone might sue you for, you'll never leave the house. Instead focus on making your treatment decisions defensible. That is to say, if someone chose to sue you for something, you'd be in a good position to defend your actions in court.

If you're confident in your assessment and that the recommended treatment is correct, you'd have no problem defending this recommendation. If you're not comfortable recommending a treatment, don't. Benadryl or a Proventil MDI are fairly harmless, but other home meds may not be. Just stay within reason and stay away from recommending something that you don't fully understand. Don't do something silly like telling someone with chest pain who's pale and diaphoretic with home rx for NTG to "put a few of these under your tongue," (I've worked the aftermath of someone's decision to use those words).
 

JonTullos

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My rule of thumb is: If I can't give it, I don't suggest it. It's outside of my scope of practice to give anything besides something like InstaGlucose, etc. so why am I going to suggest someone take a med that I can't give? Lawsuits, I want to avoid them as much as possible.

Now that said, I will not hesitate to tell someone they either need to go see their doctor or go to the hospital (if it's a true emergency). Surely that wouldn't get me sued. :p
 

BossyCow

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I call medical control and tell them that the patient has benedryl or whatever and get their okey-dokey. That way if there's an issue, it was the doc's call but if its going to help, the meds get a head start. But my average transport time is 30 minutes and my MPD is extremely supportive.
 

firetender

Community Leader Emeritus
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It's more of a situation-by-situation thing with there being only one question to answer: "If I withhold my best estimate of an action to take to relieve pain and suffering, will I be able to live with it?"
 

SoldierMedic

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My rule of thumb is: If I can't give it, I don't suggest it. It's outside of my scope of practice to give anything besides something like InstaGlucose, etc.

^^^

Solid advice... and the gentleman suggesting you contact medical control for anything they may have is a good idea. Best bet is simply advise going to the hospital.
 

DV_EMT

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ABSOLUTELY NOT!!!!! Even as a state and national pharmacy tech. You can by no means reccomend any medication. EVER. Period. The only professionals who CAN reccomend medications are Pharmacist and Doctors. Nurses are iffy and kinda can. As a basic or even a medic.... Absolutelty not. You can be sued, fired, and even lose your licence. So don't do it!!!

Sorry to come off so harsh. But having been in pharmacy for so long... It's just pounded into your head
 

Seaglass

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My rule of thumb is: If I can't give it, I don't suggest it. It's outside of my scope of practice to give anything besides something like InstaGlucose, etc. so why am I going to suggest someone take a med that I can't give? Lawsuits, I want to avoid them as much as possible.

This, mostly. Two places I work allow me to give out handouts to patients who refuse care or don't meet transport criteria for certain conditions. Those handouts recommend all sorts of stuff. But they're legally coming from PAs and doctors, not me...
 

Aidey

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I will give advice, but I rarely, rarely, rarely ever name a specific medication. For example, on something like a cold and flu who doesn't want to go to the hospital I may tell the pt something like this.

"You need to stay hydrated, and eat which will help. You may also want to see if there are any over the counter medications that can help your symptoms, like cough syrup or something to reduce your fever. Make sure that any medication you take won't interact with any medications you are taking. Also make sure that you don't take multiple things with the same medication in them, for example don't take a cough syrup and a pill that both have tylenol in them. If you have any questions or concerns about taking over the counter medications call your doctor's office or speak with the pharmacist at the store."


Disclaimer: Obviously before telling a person this I will have at the very least gotten a list of their meds, allergies and medical history, so I'm not just telling this to someone without knowing anything about them.
 

John E

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DV EMt...

Can you point to the law in California that specifically states that I can't recommend a legally obtained, over the counter medication to someone who asks me for my opinion?

John E.
 

DV_EMT

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Can you point to the law in California that specifically states that I can't recommend a legally obtained, over the counter medication to someone who asks me for my opinion?

John E.


Yes I can:

From the Ca Pharmacy Law Book


4051. Conduct Limited to Pharmacist; Conduct Authorized by Pharmacist
(a)
Except as otherwise provided in this chapter, it is unlawful for any person to manufacture, compound, furnish, sell, or dispense any dangerous drug or dangerous device, or to dispense or compound any prescription pursuant to Section 4040 of a prescriber unless he or she is a pharmacist under this chapter.
(b)
Notwithstanding any other law, a pharmacist may authorize the initiation of a prescription, pursuant to Section 4052, and otherwise provide clinical advice or information or patient consultation if all of the following conditions are met:
(1)
The clinical advice or information or patient consultation is provided to a health care professional or to a patient.
(2)
The pharmacist has access to prescription, patient profile, or other relevant medical information for purposes of patient and clinical consultation and advice.
(3)
Access to the information described in paragraph (2) is secure from unauthorized access and use.



http://www.pharmacy.ca.gov/laws_regs/lawbook.pdf

....and depending on your county. I highly doubt it says that you can "recommend" medications as a basic. As a basic... or even a RX tech for that matter.... you have no where near the knowledge of Pharmacology that a pharmacist has.
 

JPINFV

Gadfly
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1. No where in part A of your quote prohibits advice.

2. Unless the clerk at the 7-11 is a pharmacy, I'm going to take a leap and say that over the counter medications are not considered a "dangerous drug."


That said, especially as a basic, I'd be more than hesitant on recommending a medication to a patient. Want to recommend OTC medications to family and friends, sure why not? Just because you're a basic doesn't mean you have to refrain from word of mouth suggestions like everyone else. When treating a patient, you should shy away from providing patient education in areas you aren't educated in. For example, the last thing you want to do is try to explain why you advised a parent to administer aspirin to a child with a cold.
 

John E

Forum Captain
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Thanks for the reference but...

theres nothing in the law/regulation that you quoted that refers to an EMT giving advice when it's been solicited by a patient or did I miss that part?

I would also suggest that the law/regulation that you quote applies to pharmacists and pharmacy technicians who dispense prescription drugs, not to an EMT who's asked a question by a patient. The fact that you're quoting the "Ca Pharmacy Law Book" I believe lends credence to my argument, not to yours.

The county in which I work doesn't prohibit my freedom of speech so far as I know. If someone asks me a question about a legally obtained over the counter medication, I can give my opinion about it. I can't prescribe or administer it.

John E.
 

JPINFV

Gadfly
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Freedom of speech isn't going to protect you from malpractice lawsuit if some patient takes your medical advice and has an adverse reaction to a medication you suggested.
 

John E

Forum Captain
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We weren't talking about malpractice...

in the first place, secondly, as someone else so succintly put it you can be sued by anyone for anything.

Look it's real simple, if a patient asks me I'll say that I use Benadryl for allergies, I don't tell them to take it, I don't prescribe it nor do I offer it to them. Contrary to some people's comments, even EMT's are allowed to share opinions with their patients.

I'm beginning to remember why I quit posting here in the first place. (Not aimed at you JPINV)

John E.
 
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