protocal changes/differences

[emtashleyb]

Im from MD got my emt there know their 2005 protocals pretty well. Well Im here in the good old state of NC now. I joined the local rescue sqaud and I am so baffled by the differences. Here I can only give oral glucose. They cant even give activated charcol :blink: Im so confused. Im used to being able to give activated charcol, glucose, assist with a prescribed inhaler, precribed nitro and epi pens. Im scared Im going to make a slip up and then my *** will be on the chopping block. However come 09 BLS here can give narcan...... I am so confused and lost if I cant even give activiated charcol why the hell will I be able to give narcan? How do you adapt to these changes? I know I need to get a copy of nc state protocals and study them until I can say them backwards in my sleep Im just wondering how hard it will be to adapt then in 9 months when I move back to baltimore I will have to adapt again. (btw if this makes no sense Im a blonde and dont want to confuse which protocal Im supposed to be using and get my arse burnt because I have the tendency to sometime be a forgetful moron)

 

[Ridryder911]

Sorry but.....geez get over it!

Seriously, how many times did you ever give activated charcoal or even epi pen in your career? Were only talking about a few med.'s here that most are over the counter or you are assisting, not 15- 50 different types as some Paramedics have to adjust to by going from service to service or how about two different medical license that will allow you to do one thing and the other will not?

As you said, "I know I need to get a copy of nc state protocals and study them until I can say them backwards in my sleep" is just part of the job of being in medicine.

R/r 911

 

[Flight-LP]

Im from MD got my emt there know their 2005 protocals pretty well. Well Im here in the good old state of NC now. I joined the local rescue sqaud and I am so baffled by the differences. Here I can only give oral glucose. They cant even give activated charcol :blink: Im so confused. Im used to being able to give activated charcol, glucose, assist with a prescribed inhaler, precribed nitro and epi pens. Im scared Im going to make a slip up and then my *** will be on the chopping block. However come 09 BLS here can give narcan...... I am so confused and lost if I cant even give activiated charcol why the hell will I be able to give narcan? How do you adapt to these changes? I know I need to get a copy of nc state protocals and study them until I can say them backwards in my sleep Im just wondering how hard it will be to adapt then in 9 months when I move back to baltimore I will have to adapt again. (btw if this makes no sense Im a blonde and dont want to confuse which protocal Im supposed to be using and get my arse burnt because I have the tendency to sometime be a forgetful moron)

So enlighten us, when would you administer Activated Charcoal pre-hospital?

 

[reaper]

A lot of services are pulling Charcoal out of there protocols. It is hardly ever used prehospital.

 

[Ridryder911]

As well, ever try to get someone drink the stuff?

R/r 911

 

[JPINFV]

Meh, it's not even in the general SOP (there's an extra treatment module that is rarely used that has it) for EMT-Bs in California.

 

[reaper]

As well, ever try to get someone drink the stuff?

R/r 911

Yeah, that never happens willingly!

 

[emtashleyb]

Im just going off what I learned oh 4 years ago I dont even know if its still in md protocols. Im just a little confused on how this state does everything and its just adding to it. I doubt the situation will ever arise but either way I know what I am allowed to give. Apparently they pulled activated charcol off the apprartus here anyway. I called nc state ems office and apparently they have the counties do whatever they like with their own protocols they dont have to follow state. Apparently I have to go aquire some from a local station. Rather than downloading and printing them out like Ive done in the past with maryland's. Im just confused as to why an emtb would be allowed to give narcan. I thought that was an als only medication. Not to mention if they give us the ability to do it through IV we arent allowed to start IV's here if we have the certification see where my confusion comes from?

 

[Buzz]

Isn't narcan able to be given intramuscular and subcutaneously as well?

 

[el Murpharino]

Why yes it is...I've given it IM before with positive results. It can also be given down the tube - although that's a whole different ball of wax.

 

[akflightmedic]

Let us not forget the now popular intra nasal route.

Those atomizers are fantastic!!!

 

[BLSBoy]

Let us not forget the now popular intra nasal route.

Those atomizers are fantastic!!!

Damn AK, ya beat me to it!

 

[HeavyCrow]

emtashleyb, are you riding with Onslow County or volunteer squad? You gonna run into a lot of protocol changes from county to county. I'm a B with PenderEms, just below you guys, and I am sure we have some different protocols, just like New Hanover County (Wilmington) does. There is chat of letting B's admin charcoal in near future, but alot of trucks dont even have it on them because of the mess and short transport time. Most departments now want B's to be able to hookup and operate 12 lead, but not interpret. As far as protocols, our department gives us a binder with all our protocols and procedures spelled out for us. Nasal narcan is a B protocol.. We are also using a lot of things that werent even discussed in my basic class. We are allowed to give Benedryl for mild allergic reactions as well as ibuprofen for pain protocol as well as fever. When in doubt, ask your medic if you have one for a partner or a B with some more experience, and you will be good.

 

[tydek07]

Charcoal

So enlighten us, when would you administer Activated Charcoal pre-hospital?

I think I have given it only 2 or 3 times only because we still have it in our protocols... OK, I have attempted to give it more often, but 2 or 3 have actually drank the stuff.

One person downed it all, then guess what happened? ....... Yup, that was a wonderful thing to clean up!!

I personally think that it should be taken out of EMS, from what I have been hearing lately it does little to no good, because how often do we get the pt right after he/she takes the pills?!?!? NEVER Only case is if the pt downs a hand full of pills right in front of you.

That is my 2-cents on this thread

Take Care,

 

[Scout]

As a general what drugs can an american EMT B give/assist in?

 

[Sapphyre]

Depending on state and/or county. ASA, O2, Activated Charcoal, Albuterol or other "rescue" inhalers, NTG, Oral Glucose, EpiPen (for anaphylaxis only).

 

[tydek07]

Varies greatly

As a general what drugs can an american EMT B give/assist in?

Drugs EMT-Basics can give differ from service to service. It all depends on what the Medical Director allows them to have in the protocols.

Drugs EMTs can give/assist in where I work are:

O2
ASA
Nitro
Epi Pens
Activated Charcoal
Oral Glucose
Albuteral and/or atrovent Nebs
Prescribe inhalers

Now, that is what EMT-Basics are allowed to give where I work. Other services will allow/deny other medications

Hope this answered your question.

Take Care,

 

[Scout]

So no pain relief like Paracetamol (Acetaminophen) or entonox (NO + O2 gas)?

 

[Sapphyre]

no, no pain relief, at all.

 

[mikie]

I had quite a hefty protocol jump from IL to MD...

No longer can I administer
-Glucagon IM
-Albuterol (Nebulized)
-Nitro (Spray)
-ASA
-CombiTubes

And for all of those, I did not need to consult medical director for orders.

Now it's down to
-EpiPens
-Activated Charcol (need online orders)

But it's part of the state protocols to which I have to adapt to! Ya, it would be nice as a basic to 'do more' but until I'm higher trained to really 'do more,' I'll complain then (not that the OP was complaining)