Protocols You Hate

redundantbassist

Nefarious Dude
638
430
63
What are some local protocols you hate, but still have to follow? What would you do to change them?
 

Angel

Paramedic
1,201
307
83
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
 

NomadicMedic

I know a guy who knows a guy.
12,098
6,845
113
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
 

Handsome Robb

Youngin'
Premium Member
9,736
1,173
113
I check my dosing with the broselow on every pediatric arrest. I do the math myself but will always reference the tape to double check as well as ask for a double check of another paramedic on scene if there's one around. Most pediatric arrests here get a supervisor plus an ALS unit.

Now that I think about it every pediatric arrest I've had except for one I've had a supe with me.

I'm with DE, I hate the fact that pain management has caps on it.
 

gotbeerz001

Forum Deputy Chief
1,312
926
113
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
So when are u coming to ALCO?
We have all this.
 
  • Like
Reactions: DPM

STXmedic

Forum Burnout
Premium Member
5,018
1,356
113
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
They even print out individual pre-dosed sheets for the babies in the NICU. High stress and specific doses. Broslow and PediStat are wonderful tools.
 

STXmedic

Forum Burnout
Premium Member
5,018
1,356
113
Having only 5mg Versed for intubation with med control orders for combo with Fentanyl......weak
ImageUploadedByTapatalk1425748025.763405.jpg
 

DesertMedic66

Forum Troll
11,268
3,450
113
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
Ours is worse. We are supposed to use the broslow tape to get an approx weight and then go to our county wide drug sheet, find the color and then the med we want to give. It's a pain in the butt.
 

COmedic17

Forum Asst. Chief
912
638
93
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
Have you learned the "handtevy" method for pedi dosages? Takes two seconds to know pedi dosages. The broslow has many issues. Such as the epi dose is the ET tube dose, not IV dose.

Let me know if you want me to explain. It's super easy. And very handy.
 

NomadicMedic

I know a guy who knows a guy.
12,098
6,845
113
I learned the Handtevy method at a pedi workshop I took, very quick and easy. I didn't know any EMS systems had switched to it. Has yours?

And yes, you're correct, the Broslowe tape has several issues. Namely it fails to address underweight or obese children, both can impact drug dosages profoundly. But, at the end of the day, both are simply dose estimation tools.

My point was; it's always better to use a dose estimating device (or an app) when you're treating a pediatric patient. Most paramedics underestimate patient weight when asked to provide that weight for a drug dose.

It's not a subject that studied much, but this one is definitely worth a look.
http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1263&context=jephc
 

COmedic17

Forum Asst. Chief
912
638
93
I learned the Handtevy method at a pedi workshop I took, very quick and easy. I didn't know any EMS systems had switched to it. Has yours?

And yes, you're correct, the Broslowe tape has several issues. Namely it fails to address underweight or obese children, both can impact drug dosages profoundly. But, at the end of the day, both are simply dose estimation tools.

My point was; it's always better to use a dose estimating device (or an app) when you're treating a pediatric patient. Most paramedics underestimate patient weight when asked to provide that weight for a drug dose.

It's not a subject that studied much, but this one is definitely worth a look.
http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1263&context=jephc
Yep we have begun to implement it.
 

gotbeerz001

Forum Deputy Chief
1,312
926
113
Have you learned the "handtevy" method for pedi dosages? Takes two seconds to know pedi dosages. The broslow has many issues. Such as the epi dose is the ET tube dose, not IV dose.

Let me know if you want me to explain. It's super easy. And very handy.
"HANDY" :)
 

wanderingmedic

RN, Paramedic
448
61
28
I hate any protocol that includes "contact online medical control for orders." A well trained paramedic should have the discernment to know when he/she needs to consult with the doc., and when he/she can guide treatment under his/her own discretion. There is no reason a paramedic should have to call for orders to do anything within their scope, although there will be times when a good paramedic will call for orders to consult OLMC.
 

DrParasite

The fire extinguisher is not just for show
6,196
2,052
113
in New Jersey, every ALS patient requires a call to the doctor prior to walking through the ER doors. suffice it to say, I am no longer in New Jersey
 
Top