RSI and Vasopressors?

[asuwrestler]

Our department does not use RSI or vasopressors in our SOP's, so we do not learn them, for those of you who took the paramedic NRT did you have questions on any of these two???

 

[JROD]

RSI and vasopressors are part of the national scope. I can't remember the exact question I had but it was about RSI and the drugs used. If its in the national scope then you should have a basic understanding about it. The answer to any question on the test can be found somewhere in the brady book. So if its in the brady book, try to review it.

 

[Ridryder911]

RSI and vasopressors are part of the national scope. I can't remember the exact question I had but it was about RSI and the drugs used. If its in the national scope then you should have a basic understanding about it. The answer to any question on the test can be found somewhere in the brady book. So if its in the brady book, try to review it.

Actually, that is incorrect information. RSI is NOT within the current curriculum nor will be in the 2011. The only vasopressor discussed within the current curriculum is Dopamine at this time and even in the new Scope being introduced. RSI and vasopressor therapy is the reason for Critical Care Paramedic/Speciality Care Transport.

I would NOT, let me repeat.. NOT rely upon textbooks such as (specifically) Brady for knowing what is upon the test. All cardiac and respiratory information is obtained from the AHA ACLS/BLS providers manual and guideline are from the NHTSA curriculum.

R/r911

 

[JROD]

It may be my inexperience and you're probably right. However, as I said earlier, I did have a question relating to Succinylcholine as it pertains to RSI (I think). Dopamine is the only vasopressor in the book and my first question on the test was a dopamine drip calculation. I also had a question about its effects at a particular dosage.

As the test relates to the book, AHA ACLS and PALS guidelines are outlined in the book, aren't they? I haven't looked at my book in a while but I'm pretty sure those are in there. From my personal experience, every question I was asked on the test (80 or something like that) could be found somewhere in the book. If you understand the curriculum in the book, then you should have no problem with the test.

Please don't hesitate to correct me again if I'm wrong, I don't want to give false info to anyone that hasn't yet taken the test.

 

[asuwrestler]

How about LMA's are those going to be on the test?

 

[Ridryder911]

Yes, they are found according to ACLS but the curriclum does not recognize any vasopressor or for that goes any IV drip other than Lidocaine and Dopamine. As this is the criteria to disinguish speciality care transport and CCCEMT/P's as "beyond the scope of the NHTSA curriculum & guidelines".

If you did see a test question in regards to RSI, then by freak of nature it was a pilot study question as RSI is NOT a standard procedure and definitely not endorsed by NHTSA Paramedic curriclum. Even the AHA does not endorse endotracheal intubation; rather now discuss alternative airway devices (LMA/Combitube).

As I have discussed, I have just returned from NREMT yesterday and for the past four days drafting test questions. I can assure, one text over another was never discussed as mentioned one being not as good as another and vice versa. I am not aware, and definitely was not hinted that any was better. In fact, discussion was made by the group in general, upon how poor the content was lacking in all texts.

Remember, they test not so much what is in the book but what one should do. This has to be within the limit and constraints of the NHTSA EMT to Paramedic curriculum. If it is not listed, then it is not allowed. Some generalized medications such as those in standard ACLS can be used.

Testing over alternative airways such as LMA's, Combitubes are in the curriculum hence they can be tested over.

R/r 911

 

[JROD]

Are you saying that some NREMT questions can not be found in a standard paramedic book? Or just that the book doesn't meet entry level requirements for a paramedic in your eyes? I also said you were right about the vasopressor question so thank you for clarifying that.

 

[asuwrestler]

Is CPAP under the current curriculum for the CBT?

 

[Ridryder911]

Are you saying that some NREMT questions can not be found in a standard paramedic book? Or just that the book doesn't meet entry level requirements for a paramedic in your eyes? I also said you were right about the vasopressor question so thank you for clarifying that.

Not all books are created equal. Some are even wrong. Remember; it takes at least three years for most to be published. Yes, if the text is accurate then the answer to most questions could be easily found, also critical thinking skills should be thought of. Text cannot directly you teach this. One has to obtain and learn for what is best for the patient at the time.

The questions are not based out of a or any specific Paramedic textbooks. The committee can refer to them but all questions has to be clarified as if it is in the current curriculum and or AHA ACLS/BLS standards... if not; it's not on the test.

Try to remember all texts copy the NHTSA curriculum book. Their spin on how to "teach or illustrate" is what makes them not infringing a copyright. Their objectives should be close or near what the NHTSA asks but again that is a "should be'. They may go into further detail or miss the whole ship. Alike, some asking about CPR in texts versus AHA BLS Health care provider; AHA will be the sorted reference.

RSI or regional treatments such as hypothermic resuscitation will not be asked. Again such questions would be upon a trial or study treatment. Even RSI is questionable and could be considered regional or "beyond" the standard curriculum. Even questions such in regards to ethnicity, demographic, personal points such as "disheveled" will not be used. Although; it might be appropriate in some questions; remember this is a national test and assumptions could be made. Political correctness has to be considered.

R/r 911

 

[TransportJockey]

Wait, since when is a pressor like Dopamine mainly a CCT drug? It's a standard truck carried drug here in NM.