Nitrous Oxide

[boingo]

Anyone in the U.S. have a protocol for its use, especially in the ambulance? I'd like to ask a few questions.

 

[Shishkabob]

Sure, what's up?

 

[Aidey]

I used to.

I miss it.

 

[boingo]

Sure, what's up?

PM sent

 

[FLEMTP]

just be careful not to use any abbreviations, VentMedic will be right behind you to tell you that you're gonna kill someone with an abbreviation!

 

[VentMedic]

just be careful not to use any abbreviations, VentMedic will be right behind you to tell you that you're gonna kill someone with an abbreviation!

Do you not know the proper name or abbreviation of these gases?

Do you not know about standard abbreviations or what is acceptable shorthand in medicine?

Do you realize how many medical errors are made by wrong abbreviations and misplaced decimal points?

Do you know people do die from medical errors including those made in EMS? So yes, you can KILL someone very easily if you do not know what medication you are giving.

Why are do you take medical safety to be a joke?

Does Lee County EMS not provide any type of safety training for you to keep you up to date on acceptable abbreviations and the prevention of medical errors? If not, maybe it is time they are reminded about certain standards concerning patient safety in Florida as well as other states in the U.S.

 

[MrBrown]

Off the top of my head

MSO4 = morphine
MGS04 = magnesium

AF = Atrial fib
AFl = Atrial flutter

O and 0

mg and mcg

mg/mcg vs ml (seen one service where people worte eg adrenaline 1ml not 1mg

etc etc (whoops, thats an abbreviation!)

 

[boingo]

I think most places around here (Northeast U.S.) frown on MSO4 and MgSO4, the former sometimes mistaken for the latter, after all, chemistry and the periodic table might be a distant memory for some.

 

[JPINFV]

http://www.jointcommission.org/NR/rdonlyres/2329F8F5-6EC5-4E21-B932-54B2B7D53F00/0/dnu_list.pdf

 

[mycrofft]

Back to N2O.....

Don't know any around here. In late Seventies it was touted as the pain relief of the future for EMT's. I know my dentist s have not used it due to insurance and second-hand inhalation issues.

 

[medicdan]

I dont know of any US system that uses it, but as I understand, it is widely used in the UK and Australia. Check out CoEMS if you want to see it in action.

 

[JPINFV]

From what I've gathered reading forums, one of the big reasons why it isn't used more often in the US is because it can't be stored mixed in with oxygen. So you end up with a heavier device that has an oxygen tank and a nitrous oxide tank instead of one tank containing a proper mixture as is the case in other countries.

 

[EMSLaw]

From what I've gathered reading forums, one of the big reasons why it isn't used more often in the US is because it can't be stored mixed in with oxygen. So you end up with a heavier device that has an oxygen tank and a nitrous oxide tank instead of one tank containing a proper mixture as is the case in other countries.

Why is that, if you know?

 

[enjoynz]

I was told that one of the big reasons it is not widely used in the USA was because of misuse, or should I say, abuse by EMS workers.
At least that was one of the main reasons, please correct me if that is not the case now, as it seems a sad reason for not using it!
It's a real shame it is not used more in the States, as it's of great benefit to our patients, when strong meds are some distance off at times.

We have a 50% mix here, Nitrous Oxide/Oxygen (Also called Entonox). It can be stored for a good while in the portable bottles on the ambulance (Same size and not much difference in weight to o2 bottles).

You have to make sure that the bottle is tipped up and down in cold weather, so the gases mix. As they will separate, because of the cold.
It can be given from a MFR - EMT-B level of training in New Zealand, with good results.

Cheers Enjoynz

 

[JPINFV]

Why is that, if you know?

Here's an article by Dr. Bledsoe that mentions it.

http://www.ems1.com/columnists/bryan-bledsoe/articles/466853-Prehospital-Analgesia-by-EMTs

 

[reaper]

One of the systems I used to work at had Entonox, up until a few years ago. There is no law against having it on the trucks. They did do away with it due to misuse, which is sad. It is great for Fx's and minor wounds.

Our system was an in truck main unit, with wall regulators like the O2. I fought to keep it, but this was a Hillbilly system and the other crews were not as responsible with its use!

 

[Aidey]

If I remember right, the Nitrous we had was equipped with a pig tail that plugged into the O2 port on the wall, similar to the ones for CPAP. That eliminated the 2 tanks issue. We also double tagged the system to prevent misuse. The only time I know of that there was an issue was when a crew hooked up the tank wrong and it vented a bunch into the box.

 

[Sunday]

we also use Entonox here....

 

[trevor1189]

I think most places around here (Northeast U.S.) frown on MSO4 and MgSO4, the former sometimes mistaken for the latter, after all, chemistry and the periodic table might be a distant memory for some.

I'm not even sure who came up with "MSO4". "MS" would be better in my opinion. MgSO4 is a chemical formula which is acceptable in my opinion. MSO4is just dumb.

 

[VentMedic]

I'm not even sure who came up with "MSO4". "MS" would be better in my opinion. MgSO4 is a chemical formula which is acceptable in my opinion. MSO4is just dumb.

MS? Magnesium Sulfate or Morphine Sulfate or Multiple Scelerosis?

MSO4 - Morphine Sulfate and unfortunately this has been misused to where it has be "acceptable" for some. Its easier than C34H40N2O10S (numbers are subscripts).


MgSO4 - Magnesium Sulfate

Medications should be spelled out completely. Abbreviations or chemical formulas should not be used.