Mona

blindsideflank said:
Too much Asa inhibits prostacyclin which is a natural dilator found in (and released by) the epithelial cells of your vessels.
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If I recall, it does this at the doses we use, but it is not sn issue because the endothelial cells can regenerate cyclooxygenase whereas platelets cannot.

Morphine has been proven to cause harm in some studies, because of crappy health carenstaff that think the problem is fixed because the pain is gone, I don't think the morphine causes any physiological damage when used appropriately
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No one had proven anything about morphine. Only correlation has been shown.
 
MS is at our discretion, but only once all six NTG doses have been given.

Oxygen is a contentious issue. In Ontario, our guiding document (Ministy of Health Basic Life Support Standards 2007, which applies to all levels of paramedics) dictates that anyone having chest pain MUST have high concentration O2 at 10-15LPM. This cookbook approach is the bane of our existence. Many of us will give it via N/C, even though we could get in major trouble with the Ministry if it were discovered. But, as the saying goes, your pen is your only witness. :unsure:

NTG is delivered only after a 12-lead ECG is acquired (if the service has the capability) in order to rule out RVI. Administration stops after 6 does, a 1/3 drop in SBP, or if the pain disappears. Any recurrence is treated as a new episode, however only the ASA is not repeated.

ASA is always given if we believe it to be cardiac ischemia.
 
Almost forgot....the administration of medication is covered by directives issued by our Base Hospitals. As they are directives, and no longer protocols, one can deviate as long as the rational is clinically sound.
 
highglyder said:
Almost forgot....the administration of medication is covered by directives issued by our Base Hospitals. As they are directives, and no longer protocols, one can deviate as long as the rational is clinically sound.
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Cool!
 
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