Nitro before IV

[medicRob]

This is whats wrong with EMS today. COOK BOOK MEDICINE = FAIL!!!!!!


I am just so damn sick of the ignorance and lack of free thinking in EMS anymore. Makes me just want to hang it up and never look back!:excl:

 

[Leonidas1]

RMC, chewable aspirin at least 162mg (if no hx of allergies, or GI problems) NTG.04 mg/sl if systolic B/P is 100mm/hg or above.

 

[TransportJockey]

This might be a dumb question, but what does RMC stand for? I don't recall ever hearing that one before

 

[Veneficus]

This might be a dumb question, but what does RMC stand for? I don't recall ever hearing that one before

Royal Marine Commando?

 

[MrBrown]

Royal Marine Commando?

One of my professors was an ex Royal Marine Commando in the Falklands War when Prince Andrew landed on his ship to take a dump ... the boys bagged it up and sold it at the pub, needless to say that Prince Andrew never came back to thier ship!

 

[Leonidas1]

RMC (Routine Medical Care) for ALS providers in the Chicago North EMS System consists of... IV, oxygen, cardiac monitor.

 

[MrBrown]

RMC (Routine Medical Care) for ALS providers in the Chicago North EMS System consists of... IV, oxygen, cardiac monitor.

If patients go to the hospital or his GP is an IV, oxygen and cardiac monitor routine care provided to them?

So why is it that in EMS it is acceptable?

*Brown once again yells loudly that not every patients needs a bloody IV or oxygen crammed down thier throat

 

[medic417]

If patients go to the hospital or his GP is an IV, oxygen and cardiac monitor routine care provided to them?

So why is it that in EMS it is acceptable?

*Brown once again yells loudly that not every patients needs a bloody IV or oxygen crammed down thier throat

Well there's your problem, don't shove the O2 tank down their throat. :wacko:

 

[reaper]

RMC (Routine Medical Care) for ALS providers in the Chicago North EMS System consists of... IV, oxygen, cardiac monitor.

Let point you back to post #115! Read, take notes and practice!

 

[socalmedic]

This is whats wrong with EMS today. COOK BOOK MEDICINE = FAIL!!!!!!


I am just so damn sick of the ignorance and lack of free thinking in EMS anymore. Makes me just want to hang it up and never look back!:excl:

I feel that the problem is not with the field level medics, we all come out of school wanting to learn more, expand our knowledge, so forth. I feel the problem is with management and Md's who do not want us to do anything more.

It dosnt matter what my patient tells me or what I read in the 12 lead. if the machine says ***ACUTE MI SUSPECTED*** I am ordered to adhere to a particular algorithm. I know there are systems out there that allow medics to think, however Southern California is not one of those systems for any host of reasons, lets not get into the "its the Fire Departments fault" topic we already have one of those.

 

[MrBrown]

Brown- I ride big red at my main job. unfortunately it is a BLS department and I enjoy ALS.

Which bar did you pick up "Big Red" at?

 

[medicRob]

Which bar did you pick up "Big Red" at?

 

[JPINFV]

Which bar did you pick up "Big Red" at?

[YOUTUBE]http://www.youtube.com/watch?v=56S81vVDufI&feature=related[/YOUTUBE]

 

[socalmedic]

you dont want to know, she is a bit of a rough ride. she sure does get my hose hard though.

 

[MasterIntubator]

I am just so damn sick of the ignorance and lack of free thinking.......

I will agree with this... but that is a double edged sword.... free thinking with ignorance gets folks in just as much trouble. Some just free think too much, and without a good solid basic knowledge... it gets all hosed up.

 

[Charmeck]

haha trendelenburg. I'd just as soon have a line.

 

[YoungMedic]

Nothing like bottoming out the patient and increasing the infarct size because of a zealous provider.

A twelve lead and IV should be performed before any NTG is administered. Administering NTG before knowing it is not a right sided AMI is only asking for troubles the same as if administering NTG without a line.

R/r 911

Perfect, exactly what i would say/do. This so happens to be my protocols as well, for good reason.

 

[Handsome Robb]

This is interesting. I just got done with my cardiology/ECG lab tonight and actually asked my instructor this exact question. I know I am in I school and not a Paramedic so I don't know if this may have something to do with it and she told me that its best to give the NTG first then secure a line...with the explanation that its better to let the NTG start doing its thing before worrying about starting a line, but it seemed to me and seems to be pretty unanimous on here that you would want a lifeline pre-NTG just in case sh*t hits the fan....
Just some food for thought.

 

[slb862]

I learned it as O2, IV, EKG (12 lead included),ASA, vitals were done by the first responder, and then the NTG. ASA is thee only drug that is going to be of any medical benefit. I have enough people working with me, if they are not starting the IV for me, then they are handing me what I need when I ask. You don't ever want to see a pt. "crash" after giving NTG without IV fluids/IV ready. Peace Out!!

 

[usalsfyre]

While I'm happy to see a healthy respect for NTG, y'all do realize you will probably recognize the majority of preload-dependent MIs with the first set of vital signs?