"Natural Medicine" that could conflict with pt. care?

Kookaburra

Kookaburra

Forum Lieutenant
Messages
173
Reaction score
0
Points
0
I'm currently an EMT-B student, and I live in an area that is, to put it mildly, very crunchy. As in, I'm sure there are more midwives and herbalists in town than actual doctors. If I end up working in the area, or in an area like this, are there any "natural cures" that I should be familiar with, that will interact with meds I might give a pt? What are some of the craziest home remedies you have seen while on a call?

I'm a total newbie (doing my first clinical tonight!:blush:), so I'm still soaking up as many stories as I can.
 
Drug interactions

You are right to be concerned about herbs that can affect the medications that you might give. People sometimes forget that at one time these were "medicines". There are many resources for follow up.
Nursing 2009 Drug handbook by Lippincott, Williams & Wilkins.
Hope this helps! :)
 
Awesome, thanks for the title tip. I'll add that book to my Amazon list...alongside all of the emergency medical Russian/Japanese/Klingon books I have on there, LOL.
 
Not only the natural cures to worry about but also the more "pure" imported food some get. For example a product here that is popular is vanilla. But the ones imported from Mexico is often are produced with a strong blood thinner so a patient on no meds can bleed and not clot making what would normally be no big deal potentially deadly.
 
I was taught to clear out the Pt's medicine cabinet and get whatever vitamin's and supplements they are taking as well to take to the hospital with the patient just in case they are taking some sort of herbal remedy that interacts with other meds or may be causing a symptom.

That said St. John's wort is something I've come across quite a bit, even around here. It's an herbal remedy for depression, but the interactions are definitely something to be mindful of. Not so much what you would give, but other medications the patient may be taking along with. Xanax, Versed, digoxin, methadone, omeprazole, phenobarbitone, theophylline, and warfarin, among others.
 
This web site has some good listings for interactions with herbs and vitamins. It also offers some info about medicatios that deplete nutrients from the body which also result in complications. People often take supplements to counteract the other effects of various prescribed medications. Depending on where you live and the cultural/ethnic makeup of your community, many herbs are also given as prescriptions from alternative practitioners and even licensed doctors to be filled at herbal pharmacies.

http://www.publix.com/wellness/notes/Display.do?id=Index&childId=Supp_Drugix
 
Oh, thanks for the link VentMedic - def going in my bookmarks. And yeah, there's tons of Chinese herbalists/medicine people in the area.

And Buzz - ha ha, I'm imagining what the poor medics must have gone through whenever they took my grandma before she entered a SNF. When we were cleaning out her home we kept finding stashes of meds in weird places. It was like Satan's Easter egg hunt.

Has anyone ever come on scene to find the pt with some craaaazy home remedy on board? Like a live catfish taped to their leg or something-level-crazy?
 
Kookaburra said:
Has anyone ever come on scene to find the pt with some craaaazy home remedy on board? Like a live catfish taped to their leg or something-level-crazy?
Click to expand...

Working on two different coasts in cities that are mulinational, I am rarely surprised anymore and have tried to learn many cultures, religions and nationalities. Santeria and Chinese customs are just two examples. I keep a Chinese calendar handy because I never know if they are talking about our dates or their calendar dates when discussing appointments and appropriateness of the day.
 
Kookaburra said:
Oh, thanks for the link VentMedic - def going in my bookmarks. And yeah, there's tons of Chinese herbalists/medicine people in the area.

And Buzz - ha ha, I'm imagining what the poor medics must have gone through whenever they took my grandma before she entered a SNF. When we were cleaning out her home we kept finding stashes of meds in weird places. It was like Satan's Easter egg hunt.

Has anyone ever come on scene to find the pt with some craaaazy home remedy on board? Like a live catfish taped to their leg or something-level-crazy?
Click to expand...

Why do call it crazy? Many of these remedys have been used for centurys. While it may seem weird to you it is normal to them. Also you would be amazed how many of them also work and have led to the pills or treatments we use today. I still see people with moldy flour paste over infected cuts etc. Actually works as it is primitive PCN but we now know that we can just place antibiotic ointment and pills and not look so weird.
 
TBH, the truly nutty remedies I've seen/heard all came from one place...the internet. (As in, I asked people why the hell they would dress a burn with peanut butter, and the answer is, "Well, my uncle forwarded me this email..." ) And the people doing them were usually WASPs. I guess I should have separated my request for nutty remedy stories from the herbs/meds interactions.
 
Something to be aware of are the herbal names or roots of common medications, like belladonna/atropine.
 
Black Cohosh (not to be confused with BLUE cohosh): used for "woman" issues - menopause and PMS symptoms. May potentiate hypotensive effects of antihypertensives and hypoglycemic effects of insulin and oral hypoglycemics.

Echinacea: stimulates immune function and suppress inflammation. Adverse effects are rare - severe allergic reactions have been reported including acute asthma attacks and anaphylaxis. Because it stimulates the immune system it may exacerbate autoimmune conditions such as SLE and rheumatoid arthritis.

Feverfew: used for migraine HAs. Can suppress platelet aggregation and increase risk of bleeding, especially in patients using anticoagulants or antiplatelets.

Garlic: used to reduce LDL cholesterol levels and raise HDL levels, and to reduce blood pressure. Has significant antiplatelet effects and can increase the risk of bleeding. Also can increase insulin levels and potentiate effects of hypoglycemic drugs.

Ginger Root: used for nausea. Massive doses have the potential to cause CNS depression and arrhythmia.

Gingko: used to improve memory, concentration. Can suppress coagulation.

Goldenseal: used to treat infections. High doses can cause GI issues, higher doses can cause hypertension, convulsions and respiratory failure. Stimulates the uterus and is therefore contraindicated during preg.

Kava: used to relieve anxiety, promote relaxation. Can intensify the effects of other CNS depressants.

St. John's Wort: Used to treat depression. Induces hepatic enzymes and therefore can decrease the therapeutic effects of many conventional drugs. Since it decreases uptake of serotonin, it mimics the actions of SSRIs and MAOIs. Use of the herb alone is not likely to cause serotonin syndrome, but use of conventional antidepressives (SSRIs, MAOIs) in combination with St. John's increases the risk of serotonin syndrome.


Source: Pharmacology for Nursing Care, Lehne.
 
Kookaburra said:
Awesome, thanks for the title tip. I'll add that book to my Amazon list...alongside all of the emergency medical Russian/Japanese/Klingon books I have on there, LOL.
Click to expand...

emergency klingon comes in very useful with drug addicts.
 
The only case I've had in the field was at an MVA many years ago.

We found the patient, having not wore his seat belt , ejected from his car and lying on the road.
Standing over him was a lady, in what I guess you'd call 'hippy style clothing'. She was putting some drops from a little bottle into his mouth.
When I asked her what she was doing....she said I'm giving him 'Arnica'

At that stage, I'd never heard of it...so was not too happy with the fact that my patient was given something unknown by mouth.
We didn't have access to drugs charts or the net to look it up either, back then.

I learnt more about 'Arnica' after the call.
http://en.wikipedia.org/wiki/Arnica

It didn't help with his fracture of the spine...but guess it made him feel a little calmer.^_^

Cheers Enjoynz
 
Do these count?

I have seen "coining" in east asian patients
(rubbing the skin of the thorax raw with the side of a coin to relieve respiratory related issues) Don't think it works.

Potatoes placed on infection sites to "draw out the sickness" based on the physics of electrotherapy in wound healing, it might have merit, but i haven't been bold enough to try it. Certainly wouldn't suggest it without some evidence.

saw a study last year ( I forget where) where some students were going through the original remedies of Hippocrates. All I remember is Mint extract worked better than opioids for chronic arthritis. I don't have arthritis and again would not suggest something I have little knowledge about.

Anyone who worked in the southern US knows about the "sick rag" not sure what it is supposed to do, but the people are pretty serious about using it. No matter how often you take it off, they will put it back on.


My all time favorite is the drug ODs that think submersion in ice water, or stuffing ice in the pants of victims is the medical treatment. Usually followed up by dropping them off at the ED by pushing them out of the moving car. (homeboy ambulance service)

I am still waiting to see somebody come in with the Pulp Fiction intracardial Epi syringe sticking out of their breast though. :)
 
Last edited by a moderator:
I'm a current EMT-B student and in our book in the Gen Pharm chapter there is a list of herbals w/ what they are often used for. including gingkobiloba, st. John's Wort, Echinacea, garlic, Ginger root, Saw palmetto, Hawthorn leaf or flower, Evening primrose oil, Feverfew leaf, and Valerian root. We are also taught to think about asking for any herbals along with meds since most people don't put them in the same group as prescribed meds, and then report them back to the hospital
 
My favorite one so far is to walk into the home of a respiratory distress patient to find them absolutely coated, head to toe in Tiger Balm. That stuff stays in your nose, and your rig....
 
Tiger Balm?! Oh my. At least if you went on a GI bleed next you wouldn't be able to smell it. Maybe.
 
It's funny (maybe?) but, GI bleeds don't bug me. Maybe it's just that I haven't had a "bad enough" one yet? That tiger balm, though, WHEW!!!!!
 
Ugh, I can't imagine. Even with the teeny bit of Tiger balm I use, my cat runs and hides, and won't come near me.

@firecoins: I can neither confirm nor deny the presence of a Klingon "Hamlet" translation on my bookshelf... *shifty eyes*

Veneficus: I saw some pictures of coining in a paramedic text book - the book said it's harmless but it looked gnarly! Also, capsaicin (sp?) or the stuff that makes peppers hot is supposed to be really good for arthritis. And pretty much the first thing anyone asks me when they find out I'm going into emergency medicine is, "So do you get to stick needles into people's hearts?!"
 
You must log in or register to reply here.
Back
Top