Naloxone Admin By EMT's

I'll agree in my EMT school they taught us the same "known diabetic acting strangely? Give sugar, it'll save a hypOglycemic patient without harming a hypERglycemic patient" mantra. However we were also taught cool and clamy give candy, hot and dry, their sugar is too high.

Also when you're fresh out a school, you're the new guy, the FNG, the probie, so when talking to a bunch of experienced providers who are all saying the same thing and your arguing and touring your basic training as being all high and mighty? Dude its like a private arguing with a bunch of seasoned sergeants who've been in combat....basically no bueno, you are wrong. Period. Hell I've been in EMS two years and I'm STILL the FNG who's learning the difference between the real world and the text book. Have a little humility and you'll go far.
 
Jim37F said:
I'll agree in my EMT school they taught us the same "known diabetic acting strangely? Give sugar, it'll save a hypOglycemic patient without harming a hypERglycemic patient" mantra. However we were also taught cool and clamy give candy, hot and dry, their sugar is too high.

Also when you're fresh out a school, you're the new guy, the FNG, the probie, so when talking to a bunch of experienced providers who are all saying the same thing and your arguing and touring your basic training as being all high and mighty? Dude its like a private arguing with a bunch of seasoned sergeants who've been in combat....basically no bueno, you are wrong. Period. Hell I've been in EMS two years and I'm STILL the FNG who's learning the difference between the real world and the text book. Have a little humility and you'll go far.
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Still doesn't mean I should tolerate their rudeness...
 
RobertAlfanoNJEMT said:
Still doesn't mean I should tolerate their rudeness...
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From what I've seen they have been very direct with you, if you're not familiar with how EMS is you could see it as being rude but they are trying to educate you on how to best treat your patients in the field. It's very rare for a patient to truly present how the book describes them. I've have quite a few serious patients who just thought they had the touch of the flu and weren't feeling well. Bottom line a good through assessment always needs to be done to avoid missing something serious. Also medicine changes over time as new studies are conducted which have shown how lots of our treatments don't work, can be dangerous, or are based on tradition rather than any evidence of benefit for the patient. Oxygen, spinal immobilization, and drugs for cardiac arrest are some of the ones I can think of off the top of my head.
 
luke_31 said:
From what I've seen they have been very direct with you, if you're not familiar with how EMS is you could see it as being rude but they are trying to educate you on how to best treat your patients in the field. It's very rare for a patient to truly present how the book describes them. I've have quite a few serious patients who just thought they had the touch of the flu and weren't feeling well. Bottom line a good through assessment always needs to be done to avoid missing something serious. Also medicine changes over time as new studies are conducted which have shown how lots of our treatments don't work, can be dangerous, or are based on tradition rather than any evidence of benefit for the patient. Oxygen, spinal immobilization, and drugs for cardiac arrest are some of the ones I can think of off the top of my head.
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I agree and I'm all about learning and continuing education but I don't like when people try to shame me into believing I need a lesson from them.. Where I come from to get respect you have to give it too.. Maybe that's just a Jersey thing!
 
You signed your own warrant by saying "there is no more learning" in your first few posts on this forum. I like the enthusiasm, but even that needs to take a back seat at some point.

On the topic of respect, I was taught to defer to my elders. In the case of these forums, my elders in knowledge and well-informed experience.
 
I was also taught that altered plus possible DM history gets glucose.
 
Flying said:
You signed your own warrant by saying "there is no more learning" in your first few posts on this forum. I like the enthusiasm, but even that needs to take a back seat at some point.

On the topic of respect, I was taught to defer to my elders. In the case of these forums, my elders in knowledge and well-informed experience.
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I misspoke on that one I was trying to say that I will no longer be in a classroom learning I will now be learning on the streets.. But of corse everyone on here only read "there's no more learning"
 
exodus said:
What exactly will you be doing with this glucometer and how will it affect your treatment? How will it benefit or prevent harm in your patients?
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Rule out a stroke, or rule it in and activate the Code Neuro
 
RobertAlfanoNJEMT said:
There is good emphasis on securing an air way... Someone who's airway cannot be maintain by themselves is to be secured with an OPA or NPA... And BVM ventilation is done whenever adequate tidal volume is not achieved... Neither of them are difficult skills
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Yea, I don't think you have any idea what you are doing. Basic adjuncts don't secure an airway and mask ventilation is far from easy.

But you aren't doing any more learning, so I guess it's moot.
 
Tigger said:
Yea, I don't think you have any idea what you are doing. Basic adjuncts don't secure an airway and mask ventilation is far from easy.

But you aren't doing any more learning, so I guess it's moot.
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Thank you for typing that out so I didn't have to haha
 
Bullets said:
Rule out a stroke, or rule it in and activate the Code Neuro
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Give the glucose, if they don't improve within 3 minutes, it's probably neuro. And why will a BLS unit be running an ALOC call without an ALC unit enroute or there? That's not going to happen except for very rare scenarios. It's also a rarity for hyPOglycemia to perfectly mimic a stroke, it happens, but is pretty rare.

What would the problem be with simply activating the team anyway?
 
Back to the Narcan issue...

It's not in my scope of practice but it's coming in some areas. I'm sure there's training on it when you go to an area that has it.

But my somewhat stupid question is... If they're not breathing, how do you know if the had an opiate overdose? Can't exactly ask. Or do you give it out to any respiratory arrest?

(Unless the bottle of morphine is lying on the patients side... Might it be an EtOH overdose? Medical cause?)
 
RedAirplane said:
Back to the Narcan issue...

It's not in my scope of practice but it's coming in some areas. I'm sure there's training on it when you go to an area that has it.

But my somewhat stupid question is... If they're not breathing, how do you know if the had an opiate overdose? Can't exactly ask. Or do you give it out to any respiratory arrest?

(Unless the bottle of morphine is lying on the patients side... Might it be an EtOH overdose? Medical cause?)
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Pinpoint pupils is a good place to start.
 
RedAirplane said:
Back to the Narcan issue...

It's not in my scope of practice but it's coming in some areas. I'm sure there's training on it when you go to an area that has it.

But my somewhat stupid question is... If they're not breathing, how do you know if the had an opiate overdose? Can't exactly ask. Or do you give it out to any respiratory arrest?

(Unless the bottle of morphine is lying on the patients side... Might it be an EtOH overdose? Medical cause?)
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Pupils are a good indicator. Also drug paraphernalia on or around the scene (needles, spoons, aluminum foil, cotton balls, lighters, pipes, etc). Track marks on the patient. You, other responders, or bystanders on scene may be familiar with the patient also (before anyone tries to twist my words) I'm not saying that just because a patient has a history of using illegal drugs means that is the medical issue with them currently.
 
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RedAirplane said:
Back to the Narcan issue...

It's not in my scope of practice but it's coming in some areas. I'm sure there's training on it when you go to an area that has it.

But my somewhat stupid question is... If they're not breathing, how do you know if the had an opiate overdose? Can't exactly ask. Or do you give it out to any respiratory arrest?

(Unless the bottle of morphine is lying on the patients side... Might it be an EtOH overdose? Medical cause?)
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Edit: Pretty much what Desert said... beat me to it. Situational awareness.
 
I must admit I'm really surprised by many comments. Narcan has been standard here for years for all opiate overdoses. Its safe and effectiveif the delivery method is well thought through. Years back our protocol was IV Narcan by MICA medics only with road crews ventilating. Not a good combo because IV is too abrupt wakes the pt quick, so MICA's would tell the crews to hold off on ventilation for a bit till they got a line in and administered. Result was heroin user waking up in withdrawal and hypoxic hangover big time. Guess who he took aim at for feeling this way? Later it was changed. Lots of good ventilation and IM Narcan. Slow gentle onset, no hypoxia. Result? "Urgh sorry guys, was I really out of it -od'd?" It has been one of our most effective CPG redesigns ever. The other thing to think about is prescription med abuse/theft/doc shopping (mostly OTC opiates like OxyContin) is now larger than all the illicit drugs combined. So you may well need Narcan for all those codeine and Oxy OD's. Give it IM with lots of the good gas before hand.

MM
 
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