Medication Errors in EMS

medic417 said:
911 as is the other service I mentioned.
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As I mentioned above, so do we! I'm just an uniformed moron, and going to go exit this thread and go study my basic pharm classifications. Because obviously, I have completely forgotten the most simple of stuff.

Pharm was always my weakest subject, but good lord... There was just no excuse for my earliest comment. Good thing I'm still a long, LONG way off to being medic.

Basically what I'm saying is this: Expect, as I get into my last three semesters (I thought I had two left, but that was looking at purely credits. With the paramedic degree plan, I have more like 3 or 4 :( ) expect me to be a regular figure in the ALS section, asking you guys so many questions you'll want ban me to just stop the spamming.
 
akflightmedic said:
Vent, you ask the question that I wanted others to ask..why would a ground 911 service carry antacids?

As for the steroid aspect, we did indeed initiate this treatment for asthmatic patients. In the flight program due to remoteness, we administered abx prophylactically most times for certain injuries, and back to the ground program we had a spinal injury guideline as well for steroid administration.
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We may start the antacids on IFT (not 911) especially if we are bringing back to our own facility or if we know what another facility routinely uses. However, for some flights, it is best to slim down especially if you have 6 - 10 other meds running and other accessories such as an iNOvent attached to your regular transport vent or IABP or whatever technology you are moving with the patient. Again, it may also vary with the distance or if it is an intercontinental flight.

However, for IFT, we may consult with our M.D. or rec'g physician before we start some antibiotics especially with certain pressors. For IFT, we can not claim ignorance as we will have lab values in front of us. Starting something that may further exacerbate renal failure especially in combination with meds or disease processes may change many things including the facility that we transport to. For example, it may now be wise to transport to a facility that does CVVH.
 
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Do you think time to a facility or time of injury is more important when considering steroid administration for a spinal injury?

Is a 10 minute transport not significant enough to start steroidal loading?

Do you know how long it takes steroids to start to work?

Do you know the physiology of what is usually happening when there is a spinal injury with neuro deficits?
 
akflightmedic said:
Do you think time to a facility or time of injury is more important when considering steroid administration for a spinal injury?

Is a 10 minute transport not significant enough to start steroidal loading?

Do you know how long it takes steroids to start to work?

Do you know the physiology of what is usually happening when there is a spinal injury with neuro deficits?
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I'm admitting defeat! White flag!

Seriously, though, I THINK I do know the physiology. I THINK I know how long it takes steroids to work. But as I have already made enough of a fool of myself today and shown my obvious ignorance in the med department, I'm just going to back out of the thread and defer the original poster to your guys knowledge in this area.
 
I was merely providing rhetorical questions, food for thought, so you may go research and expand.
 
akflightmedic said:
Do you think time to a facility or time of injury is more important when considering steroid administration for a spinal injury?

Is a 10 minute transport not significant enough to start steroidal loading?

Do you know how long it takes steroids to start to work?

Do you know the physiology of what is usually happening when there is a spinal injury with neuro deficits?
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The steroids for SCI is still controversial. Some patients benefit and for some they can cause more problems. Not all SCIs are the same and if they are on their way to the OR, we defer the steroids.
 
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Oh, trust me AK, I'm already digging through my old notes right now. I start Adv. Pharm on Monday, and I apparently don't remember basic pharm.

So, yeah, consider me officially and completely humbled as of now.
 
Wow, this thread took a hard left turn. One thing about EMTLife, there's always an interesting discussion! Thanks for the articles, those will help.

Still though - any one have an actual published article or case study about a specific instance of improper medication administration? The "Bad Medicine" article has some scenarios, but I need an actual case with names, dates and outcome, if possible.

If anyone has something like that tucked away, please send it my way. Thanks!
 
makphisto said:
Still though - any one have an actual published article or case study about a specific instance of improper medication administration? The "Bad Medicine" article has some scenarios, but I need an actual case with names, dates and outcome, if possible.

If anyone has something like that tucked away, please send it my way. Thanks!
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If you look at the references from each article especially "Bad Medicine" you will fine the court cases. If those links don't work you can still do a search for the actual case.

Always look at the references at the end of any article you read to see where they are pulling their information. Don't just take a "JEMS" author's word that it is true.
 
Well, those aren't exactly what I'm looking for, but I'll keep looking. Thanks.
 
makphisto said:
Well, those aren't exactly what I'm looking for, but I'll keep looking. Thanks.
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Maybe not but they do show the consequences for the patient, Paramedic and the company when a med error is serious enough.

As well, infiltrates with medications that go unnoticed bring about very back results.
 
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