Nitro before IV
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TransportJockey
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What do you mean medical control? They usually don't even know I've give ntg until I call my report into the receiving facility.
Shishkabob
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Maybe you have some restrictive protocols as an Intermediate, but luckily as a Medic, there is VERY little I even have to notify med control about... and giving NTG to chest pain isn't one.
Paramedics out here have to notify medical control just the same as EMT-I's do. Our protocols are on the stiff side, but it makes great patient care and it only takes two seconds! No Biggy! I think it works great! Infact we got an award for patient care not to long ago for it, but that's great it works different for you fella's!
18G
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Ummm... calling "Mother May I" for something like nitro and everything else is not a good thing. Do you need to call med command to give aspirin and start an IV?
*Brown smashes his head on the desk
You do not need an IV in place to give freaking GTN, if your patient is that shut down and crook you are worried some GTN is going to make them keel over maybe they shouldn't be getting GTN?
High flow oxygen helps everybody too right?
You do not need an IV in place to give freaking GTN, if your patient is that shut down and crook you are worried some GTN is going to make them keel over maybe they shouldn't be getting GTN?
High flow oxygen helps everybody too right?
TransportJockey
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But... the protocol book says we must and it's always right isn't it? And of course high con 02 helps everyone, there are no contraindications, so it must be the miracle drug, just like NS
Calling for NTG...do you guys have th big orange box you plug into the patient's phone line to fax lead II as well?
While I do agree with having an idea of what's going on before treating calling for NTG is a moronic gesture. Get a 12 lead, then start treating. Do your medics ask for permission to have a BM as well?
We start NTG infusions without talking to a doc here, not to mention call our own STEMIs...
More to do with ruling out an RVI in the presence of IWMI, where in about 90% of the population, blood supply to the AV node is fed by the RCA. A decrease in perfusion to a particular group of cells will ultimately decrease its function - not to mention the vasodilatory effects on preload the GTN will have - which in turn, could substantially decrease CO.
I would say caution should be advised, and at least hook them up to the 12-lead first. Assess, then treat - in that order. Always.
Nothing we can't handle ourselves. Calling MC for GTN at the medic level is just embarrassing and it is not beneficial for the patient to see a so called professional having to ask permission for something so basic. The average Joe in the street could do the same.
You will usually find that counties which have such primitive restrictions are a result of previous f***k ups by providers in the past.
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Hmmm
So, our policy as an als transporting agency is that a line before Nitro is highly advised. But not having a line isn't a contraindication to Nitro. So hi everyone, I'm new, got my registry coming up in a couple months and this thread got me thinking about how it's time to focus on localizing MI's, especially MI with suspected right ventricular involvement..
I've got Dubin's Orange book on EKG's, which helped told me to watch leads II III & AVF to indicate inferior MI, also that hypotension & JVD are often present, what else?
So, our policy as an als transporting agency is that a line before Nitro is highly advised. But not having a line isn't a contraindication to Nitro. So hi everyone, I'm new, got my registry coming up in a couple months and this thread got me thinking about how it's time to focus on localizing MI's, especially MI with suspected right ventricular involvement..
I've got Dubin's Orange book on EKG's, which helped told me to watch leads II III & AVF to indicate inferior MI, also that hypotension & JVD are often present, what else?