Medications EM-B's can use.

[fm_emt]

Supposedly they're considering letting us carry Epis and MDIs as well as a few other things and maybe letting us start IVs but of course they're going to talk about it for a year and then it'll never happen, so....

I've heard rumors that they might let us administer Epi (with an epi-pen) in the near future. Even if we have to take an 8 hour class just for the epi-pin, that's fine with me. We've run into a few situations where an epi-pen would have been great to have and use, but we didn't have it & couldn't use it.

I think that in the case of things like Epi-pens, we oughta be able to use them, especially since any Tom, ****, or Harry can get one from Walgreens. yes, they're prescribed, but shared around with impunity.

Same with ASA. Want us to take a special class for it? Sure, I have no problem with that.

 

[MICU]

Is it me or our BLS team is the only one without any real drugs.

 

[Guardian]

uhhh... anyone can give any medication when properly trained, and taught the indications and contraindications thereof.

Another thing.... what would it harm for anyone to be able to give Glucagon?

well, for starters, they could accidentally kill someone.

 

[trauma1534]

well, for starters, they could accidentally kill someone.

Now tell me how Glucagon can kill someone?

And on top of that, Morphine can kill someone, valume can kill too. Nitro can cause someone to bottom out and it not corrected it too can kill someone. Every drug on the truck can kill someone no matter what level is giveing the drug.

I think we are just making excuses as to why EMT-B's can't function.

Anyone can have an allergic reaction to any drug. If not corrected, it can kill someone.

Any EMS provider is one patient away from possably killing someone! Let's not get tunnel vision folks!

 

[FFEMT1764]

Every drug on the truck can kill someone no matter what level is giveing the drug.

I have never heard of Narcan killing anyone. Same thing for oxygen. I think that basic's should have a few drugs, nothing fancy though. Simple stuff like D50, Albuterol, and maybe diphenhydramine. The rest should be maintained to the ALS level...and I don't think basics should do any cardiac meds as they need to be monitored while being given the meds.

 

[jeepmedic]

I have never heard of Narcan killing anyone. Same thing for oxygen. I think that basic's should have a few drugs, nothing fancy though. Simple stuff like D50, Albuterol, and maybe diphenhydramine. The rest should be maintained to the ALS level...and I don't think basics should do any cardiac meds as they need to be monitored while being given the meds.

Glucagon is a lot safer than D-50. Glucagon should be used with caution on pts using blood thinners (Warfarin), and beta-blockers (propranolol). Also with pts who are pregnant.

Now if you give D-50 you have to have an IV. And if that IV should blow while you are giving the drug guess what? You have tissue necrosis.

 

[FFEMT1764]

Our protocols, statewide, require IV attempts prior to giving glucagon, so thats why the D50 reference. And that would only be given by our EMT-I's as basics cant do IV's here, yet. That may change in a few years...depends on the state EMS med director.

 

[trauma1534]

Our protocols, statewide, require IV attempts prior to giving glucagon, so thats why the D50 reference. And that would only be given by our EMT-I's as basics cant do IV's here, yet. That may change in a few years...depends on the state EMS med director.

Good attempt to come back, but the topic is Drugs EMT-BASICS can give. We were first discussing with your previous posts that you thought that EMT-B's should be allowed to give D-50. Now you are changing it to I's??? Dude, I's can already give everything a Paramedic can in this area, except for RSI. That is the single only difference between the two here.

 

[Pablo the Pirate]

well i think with the proper training just about anyone can give drugs. EMT-Bs are by no means stupid and they are highly trainable. Remember that all "Paragods" started out as "nothing better" than EMT-Bs. Medics may save lives but basics save your paramedic :censored: :censored: . It kinda sounds like some of you should remember that. with that being said as a basic i could give 325mg ASA, Nitro that we carry, glucagon, oral glucose, O2 of course, albuterol nebs, and NS IVs all that standing orders. with med control Activated charcol and Epipen. and it's not really a med but we combitube also. In my section of the US basics can do alot of skills and i think it's great. thats just my 2 cents

 

[jeepmedic]

well i think with the proper training just about anyone can give drugs. EMT-Bs are by no means stupid and they are highly trainable. Remember that all "Paragods" started out as "nothing better" than EMT-Bs. Medics may save lives but basics save your paramedic :censored: :censored: . It kinda sounds like some of you should remember that. with that being said as a basic i could give 325mg ASA, Nitro that we carry, glucagon, oral glucose, O2 of course, albuterol nebs, and NS IVs all that standing orders. with med control Activated charcol and Epipen. and it's not really a med but we combitube also. In my section of the US basics can do alot of skills and i think it's great. thats just my 2 cents

You have opened that can of worms again. :unsure:

 

[FFEMT1764]

Dude, I's can already give everything a Paramedic can in this area, except for RSI. That is the single only difference between the two here.

I thought VA had EMT-shock trauma. I didnt know they also had I's. I think that the whole EMT I thing should go away, and I was and I for 8 years...update the B program and beef them up, do away with the I, and then just have B and P. Just a thought though. And it is interesting that an I can give controlled meds...but hey if thats allowed there good for you.

 

[jeepmedic]

I thought VA had EMT-shock trauma. I didnt know they also had I's. I think that the whole EMT I thing should go away, and I was and I for 8 years...update the B program and beef them up, do away with the I, and then just have B and P. Just a thought though. And it is interesting that an I can give controlled meds...but hey if thats allowed there good for you.

VA. changed the levels about 2 or 3 years ago. we now have EMT-Basic; EMT-Enhanced; EMT-Intermedite; and EMT-Paramedic. I think it is to many levels but In some areas of the state you don't have any where for the providers to take a EMT-Intermedite or Paramedic class. The Enhanced is almost the same thing as a Shock Trauma.

 

[FFEMT1764]

Ok i was wondering...now I am no longer confused. Thanks for explaining it. I know MD still has the CRT (or did when I moved back here in 2000)

 

[jeepmedic]

Ok i was wondering...now I am no longer confused. Thanks for explaining it. I know MD still has the CRT (or did when I moved back here in 2000)

I'm glad you are not confused because I teach here and I am :wacko:

 

[fyrdog]

Eventually EMT-Bs will be giving all the meds that paramedics can give. The easiest way to get to that point is to become a paramedic now and you wont have to wait. I dont understand why places take the paramedic ciriculum and strip it down so EMTs can do part of it.

If you want to do paramedic stuff become a paramedic. It's as important to learn why you doing something as it is to learn how to do it. It is also important to know why not to do something when everyone thinks you should.

I do think some of the additions for EMTs are good ie. AEDs assisting a patient with thier medications, assistining with setting up IVs and EKGs.

And I do believe EMTs are valuble to paramedics and should be treated with respect and included as team players.

 

[davis513]

Well I didn't see anyone post for North Carolina so here goes...

Per the North Carolina Medical Board's "Approved Medications for Credentialed EMS Personnel" revised as of 05-02-2006:

"EMS personnel at any level who administer medications must do so within an EMS system that provides medical oversight. Personnel must follow written treatment protocols and must complete appropriate medical education. All EMS System protocols and policies must be reviewed and approved by the Medical Director of the Office of EMS."

The List for EMT-B's includes:

Acetaminophen

Aspirin

Atropine (As a component of preparedness for domestic terrorism, EMS personnel recognized by the EMS System may carry, self-administer or administer to a patient atropine and/or pralidoxime, based on written protocals and medical direction, by auto-injector only.

Beta Agonist Preparations (Limited to patients who are currently prescribed the medication. EMT use may be through any inhaled method of administration).

Activated Charcoal

Diphenhydramine - (oral route only)

Epinephine - (Liminted to treatment for anaphylaxis and may be administered only by auto-injector).

Narcotic Antagonists - (Limited to naloxone by intra-nasal route).

Nasal spray decongestant

Nitorglycerin - (Limited to patients who are currently prescribed the medication.)

Non-prescription medications

Non-steroidal anti-inflammatories

Oxygen (Does not require medical directions)

Pralidoxine (As a component of preparedness for domestic terrorism, EMS personnel recognized by the EMS System may carry, self-administer or administer to a patient atropine and/or pralidoxime, based on written protocals and medical direction, by auto-injector only.

 

[Ridryder911]

Remember that all "Paragods" started out as "nothing better" than EMT-Bs.

I do wish people would stop saying that.. Nearly half of my staff was never a Basic EMT...nor practiced as such, and they are very good medics. In many locations one has to never has to be a Basic EMT. In fact most of our Paramedic programs are now suggesting entry level from nothing to Paramedic level. This was from suggestions by local EMS administrators whom preferred to hire Paramedics and develop "their own" style without any predisposed attitudes.

So not (all) Paramedics were Basic levels... that is a myth.

I am wondering what "non-steroid anti inflammatories" they are administering?

R/r 911

 

[Stevo]

why am i constantly reading here that a paramedic is the end all solution to ems?

yes i like paramedics when it gets heavy

no , they are not needed on every single call

yes, a good emt recognizes the need for a paramedic

no, emt's are not playing paramedic in their absence

it's been that way here for decades, and it has managed to work rather well imho...

~S~

 

[Ridryder911]

I understand we are not needed on every call... but would it not be better to be have one on every call then to have to wait or not have one at all ? An AMI, patient with extreme pain, respiratory distress, MVC's may not need one but again having the patient to await an additional ten minutes for that breathing treatment or antiarrhythmic or chest decompression can and does mean the difference between life and death..... So yes we have been doing certain things for decades, but this does not mean they are always right.

R/r 911

 

[Stevo]

it would be best to have an MD on every call for the patient's benifit ,but it's unrealistic to expect it, and the cost of instituting anything like that (as an emt-p) via mandatory requirement would sink ems overnight

and i personally think the majority of what i see not working in ems is due to the changes being made by the powers that be.

they are constantly trying to fix what is not broken, and provide little to nothing for validation in doing so.

i am not going to bow down to their, or your what if sceanrios Ryder , they are about as valid as what if the earth flys into the sun, we need more blitz line

IF you want change, start at the bottom, not the top. convince basics , as well as dispatch, of the need for als, what to look for, when to call

a good basic will always be als's biggest advocate, to base your assumption that change is needed because basics and I-techs try to play paramedic is the biggest crock i've heard in my entire carear

i highly suspect that your constant lamenting of basics , their training, thier street performance is a manifestation of your personal frustration ...

let it go

~S~