Medication lists

[Silver_Star]

Today, a nurse asked me why we need the medication lists. And quite frankly i had no idea. We don't administer any medications. So why do we need the med list?

 

[Dominion]

A med list is a good idea because depending on where you are transporting that patient the receiving facility is more than likely going to want to know what their on. This is for many different reasons:

You can get the most detailed medical history by what medications the patient is taking. Most elderly have a ton of medications and have no clue why they are taking them and will frequently tell you they don't have any medical problems (despite the 2 page medication list).

If the receiving facility wants to give a medication to the patient it's a good idea to know what they are on because some medications cannot be taken together. An easy example of this would be a patient that shouldn't take Nitro within 48-72 hours of taking the viagra (or other similar ED medication).

Many times patients will have extended stays at the hospital and will be on their home meds while admitted. While they may not take the same medication as they do at home the docs can better assess what medications they DO need take while admitted.

 

[medichopeful]

Today, a nurse asked me why we need the medication lists. And quite frankly i had no idea. We don't administer any medications. So why do we need the med list?

Ok, I'm assuming you mean the lists that a patient gives you. The EMT-B is, for all intents and purposes, just the first step in the process of medical care. Part of our job is to gather as much information as possible, which we will then be able to hand off to the more advanced providers who will actually be able to use the information and start giving the patient the care they deserve. When we get medication lists, we are finding out about the patient's condition, what drug interactions there are or could possibly be, and what the advanced providers should look for and expect. For example, if you get a patient who is on Lisinopril, you and everybody else will know that they may have high blood pressure, which could help when it comes to figuring out what is going on with them. An advanced provider could also learn from this that maybe giving them drug X may not be a good idea, because they could interact and potentially harm the patient.

So basically, the information we obtain about meds is not JUST for us. Yes, it can be useful, because we may get some useful information, but it is for the people we hand the patient off to as well. Just like we can do very little about tenderness in one of the abdominal quadrants, but we can pass the information along. Does that make sense?

If I assumed incorrectly and you meant something else by "medication list," well you know what that means

 

[Dominion]

Also if you are planning on advancing yourself in anyway when you get those med lists, make a copy. After the run or later at home get that list out and look the medications up. No need to memorize it but after awhile you will start to notice patterns. It's good to know what the medications are commonly used for, what possible side effects are etc.

Additionally if you have a PDA style phone (iphone, windows mobile, blackberry, android) get epocrates and install it. The greatest tool you can use. It's great if you get a patient on some med and is not acting right. Takes just a couple minutes to look it up and see if that is an adverse reaction.

 

[Silver_Star]

I should have been more specific. My question was more directed at why do we need a copy of med lists for our records?

 

[Shishkabob]

Because it's part of the patient care record and you need to know all you can about your patient. It is your responsibility to know what medications are used for what.



You as an EMT may be limited to only 6 drugs, but that doesn't mean you're limited to knowing only those 6 drugs.

 

[8jimi8]

Also if you are planning on advancing yourself in anyway when you get those med lists, make a copy. After the run or later at home get that list out and look the medications up. No need to memorize it but after awhile you will start to notice patterns. It's good to know what the medications are commonly used for, what possible side effects are etc.

Additionally if you have a PDA style phone (iphone, windows mobile, blackberry, android) get epocrates and install it. The greatest tool you can use. It's great if you get a patient on some med and is not acting right. Takes just a couple minutes to look it up and see if that is an adverse reaction.

great way to violate hipaa. Write the drugs down, do not copy any portion of any persons medical records for your own use. D you know better

 

[Dominion]

great way to violate hipaa. Write the drugs down, do not copy any portion of any persons medical records for your own use. D you know better

ACK! thanks for catching that. I MEANT to add i nthere "If you make a copy make sure you DO NOT include ANY identifying factors, cover up any personal info first"

:wacko:

 

[8jimi8]

No worries D, I knew that you meant to include it!

not to be hypocritical, just to drive that point home.

i have saved copies of rare 12 leads. just make sure you do not have any identifying information.

And i would add the caveat that as professionals we would strive to preserve these bits of information only for education.

Any other intention is exploitation.

(i suppose keeping copies to learn from is still exploitation...)

 

[Dominion]

No worries D, I knew that you meant to include it!

not to be hypocritical, just to drive that point home.

i have saved copies of rare 12 leads. just make sure you do not have any identifying information.

And i would add the caveat that as professionals we would strive to preserve these bits of information only for education.

Any other intention is exploitation.

(i suppose keeping copies to learn from is still exploitation...)

I will say that when I was doing cardiology we had a TON of 12 and 4 leads straight from a lifepack 12 with no ID info on them. It was immensely helpful to learn to read the EKG's with ACTUAL strips from ACTUAL patients. There were no answer keys, we'd get strips out, find our own opinion and then discuss the merits of each strip in class. Was a great way to do it.

Now typically with me, if there is a medication that I don't recognize or remember what it's for I will A. ask the patient. B. Go ahead and look it up in epocrates.

 

[Aidey]

I have 2 folders full of 3 and 12 leads from the past several years with all of the pt info removed. On many of them I've written the basics like "74, male, Chest pain", just to give a bit of context to the strip.

I have Epocrates so if there is a medication I don't know I just look it up. I have made copies of hospital/nursing home generated med lists in the past, usually when we're transferring a patient from a hospital or nursing home that are very close together and I haven't had time to write them all down yet. In those cases the lists get shredded with all the other notes and scratch paper when I'm done with them.