Should dispatchers tell callers how to give allergic reaction medication?

[MMiz]

Should dispatchers tell callers how to give allergic reaction medication?
Austin EMS officials push for national standard on giving instructions over the phone.

On the day she dialed 911 in November, the caller knew from a previous near-fatal experience that her 80-year-old husband was probably having a severe allergic reaction and needed an urgent dose of a potentially life-saving drug.

She told the dispatcher, a trained paramedic, that she had a shot of epinephrine at hand but wasn't sure how to give it.

Under Austin-Travis County Emergency Medical Services rules, the dispatcher wasn't supposed to tell her.

Read more!

 

[LucidResq]

Ok, tangent... but what the heck is up with this picture? Why is she wearing a face mask? And what's with her nails?!

It's like the reporter needed a picture for this story so he grabbed his 16-year-old daughter, had her wear a face mask and hold an epi-pen.

"Honey... try to look... you know... medical-ish"

 

[Mountain Res-Q]

Should dispatchers tell callers how to give allergic reaction medication?
Austin EMS officials push for national standard on giving instructions over the phone.

On the day she dialed 911 in November, the caller knew from a previous near-fatal experience that her 80-year-old husband was probably having a severe allergic reaction and needed an urgent dose of a potentially life-saving drug.

She told the dispatcher, a trained paramedic, that she had a shot of epinephrine at hand but wasn't sure how to give it.

Under Austin-Travis County Emergency Medical Services rules, the dispatcher wasn't supposed to tell her.

Read more!

On a case by case basis, their might be arguments for and against this. The problem is, IMHO, I don't trust dispatchers. My dispatchers are idiots. While I will not classify them all as such, does anyone here really believe that all the dispachers that they deal with are smart enough? On the other hand, most dispatchers have a roladex at hand with "cheat sheets" to dirrect callers how to do CPR, control bleeding, etc... I'm confused as to why it is against protocol for her to do so. A true severe alergic reaction with respiratory issues ranks pretty high on my emergency list, so as a Paramedic, why didn't she violate what is obviously a stupid protocol, just as the medics who treated that dog in Canada did?

 

[Sasha]

^_^

Ok, tangent... but what the heck is up with this picture? Why is she wearing a face mask? And what's with her nails?!

It's like the reporter needed a picture for this story so he grabbed his 16-year-old daughter, had her wear a face mask and hold an epi-pen.

"Honey... try to look... you know... medical-ish"

Her nails are so tacky looking!

As for the face mask.. maybe someone with TB was having an allergic reaction! ^_^

 

[rescuepoppy]

Speaking from a dispatchers point of view. As long as the EMDPRS is in place to allow us to advise on the use of prescribed Epi-Pens I think it should be allowed. The key would have to be emphasizing to the caller that the meds are being used on the patient they are prescribed for. Added to our protocol cards already in place this could be another tool and one that could make a difference in the outcome of a call.

 

[marineman]

If the caller can't figure out how to use it on their own then I say no. Nothing against dispatchers on this but I've heard the horror stories from providers getting an epi pen through their thumb while trying to save a patient, I don't think it would be a good idea to have joe blow go try it, then I end up with 2 patients and definitely don't like that idea.

 

[reaper]

Nothing like getting on scene to a severe reaction, with the wife going 90mph through the house. Then you realize that she injected her thumb while trying to help husband!!

Most it will not harm them, but some it can. So you end up with two pt's, because you do need to evaluate the wife now!

 

[CAOX3]

If the caller can't figure out how to use it on their own then I say no. Nothing against dispatchers on this but I've heard the horror stories from providers getting an epi pen through their thumb while trying to save a patient, I don't think it would be a good idea to have joe blow go try it, then I end up with 2 patients and definitely don't like that idea.

If the alternative is death. Then I would say yes.

Children are prescribed epi-pens and taught how to use them.

 

[LucidResq]

If the caller can't figure out how to use it on their own then I say no. Nothing against dispatchers on this but I've heard the horror stories from providers getting an epi pen through their thumb while trying to save a patient, I don't think it would be a good idea to have joe blow go try it, then I end up with 2 patients and definitely don't like that idea.

I've seen a paramedic demonstrating what he thought was an epi-pen trainer, after being asked by an EMT-B student "if that's a trainer why does it have an expiration date?", stab himself in the thumb.

If someone can't figure out something as simple as an epi-pen on their own, I fear what would happen if they are panicked and being instructed by someone else by phone.

 

[STATION4]

Hey Moutain Res-Q your hand a tied when you are a dispatcher.The dispatcher was following protocol.Hey we might read of cards thats what our protocols tell us.And where i'm from most of our dispatchers are EMT so our hands are tied also.Where ever you get dispatcher are stupid why dont u try doing it and u might get what a dispachers go through.

what other commits do u have now??

 

[EMTinNEPA]

Hey Moutain Res-Q your hand a tied when you are a dispatcher.The dispatcher was following protocol.Hey we might read of cards thats what our protocols tell us.And where i'm from most of our dispatchers are EMT so our hands are tied also.Where ever you get dispatcher are stupid why dont u try doing it and u might get what a dispachers go through.

what other commits do u have now??

Tunkhannock, eh? Do you dispatch for Wyoming County or Luzerne County?

Edit: Disregard, I just read your post in the Intro thread.

p.s. I work for Medic 12 and 15 out of Luzerne County... you and I may have worked together before.

 

[STATION4]

Hey EMTinNEPA yes i do work for Wyoming County 911 Center.Good to hear from someone from around this neck of the woods 10-4...

 

[EMTinNEPA]

There are actually more of us than you may think. Artman works down in Snyder County and I think I talked to a guy from Schuylkill County before.

But back on topic...

If the dispatcher is also a paramedic, than they should be able to explain how to use an epi-pen. Even if the dispatcher is an EMT, they should be able to explain how to use an epi-pen. If the patient has a prescription for the epi-pen, even better. It doesn't take a rocket scientist to use an epi-pen properly. But then again, a panicky wife might not exactly be a rocket scientist. I'd use caution, but try to get her to use it.

 

[bmennig]

I see your logic EMTinNEPA, absolutely. I agree 100% that we should be able to, however in the dispatch world "if it's not in our fantasic EMD protocol, you can't tell them to do it". The EMD we use (in Wyoming County) is quite extensive, however, very hard to navigate through. I just looked at it and all we can tell the caller is that "if they have medication perscribed by the doctor for this type of situation, use it now as directed" It tells nothing of how to inject it what so ever. While I can definately tell somebody how to use it, we can't vary from the protocol.

FYI: we use the National Academy of Emergency Medical Dispatch protocol... It's a real treat to use

 

[EMTinNEPA]

The idea behind epinephrine auto-injectors is to deliver epinephrine as quickly as possible to counter-act a severe allergic reaction. My ALS service is the only one around here that actually carries epi-pens, because they came to the conclusion that actually establishing IV access, then drawing up epinephrine in a syringe and administering it was too time-consuming. If the husband is having legit and severe anaphylaxis, no point in NOT using the epi-pen. It will probably save his life.

A good paramedic/EMT/dispatcher knows when to deviate from protocol and avoid cookbook medicine.

 

[Mountain Res-Q]

Hey Moutain Res-Q your hand a tied when you are a dispatcher.The dispatcher was following protocol.Hey we might read of cards thats what our protocols tell us.And where i'm from most of our dispatchers are EMT so our hands are tied also.Where ever you get dispatcher are stupid why dont u try doing it and u might get what a dispachers go through.

what other commits do u have now??

I have no doubts that there are many GREAT Dispatchers out there, including yourself, I hope. But with all due respect, you don't know the Dispatchers where I am from. I've got the stories. I fully understand that Dispatchers don;t have an easy job. It can be as hard as being in the field. But 90% of teh Dispatchers I have "worked with" don't seem to understans that our job ain't easy either. Unfortunately, most of my Dispatchers have no real emrgecny service training. I have problems with Dispatchers from my experiences with my mentally challenged ones (seriously-I don't trust most of them and neither do any of the people I work with becasue of many near misses and screw ups that endanger lives, mostly ours). I have no problem with this particular Dispatcher, just this particular set of circumstances that placed her in a no-win situation. But if you are one of the good Dipachers then all I can say is that I can get you a job if you want to move to the Sierra Nevadas.

 

[bmennig]

how good do they pay?

 

[Mountain Res-Q]

how good do they pay?

Based on looks alone: Well enough to afford candy and cake every day, but not enough for a make over.

Seriously, my biggest problem was that all EMT's and Medics were required to do 12 hours of "Dispatch Time" once a year to see how bad the Dispatchers have it. Meanwhile, they didn't have to join us out in the field to see what our side had to deal with. Didn't seem fair. Our jobs are all difficult in their own way, so we should create mutual understanding so that we act as a team. My job is hard, your job is hard, I make your job easier, you make my job easier, and we are all friends. Maybe that is how it is in your neck of the woods... but not in mine, sadly.

 

[STATION4]

we are trying to get it so that we go out in the field and the police and fire and ems comes in to sit and see what goes on in the 911 center...it will be good for all of us here in Pennsylvania Wyoming County.

 

[Mountain Res-Q]

we are trying to get it so that we go out in the field and the police and fire and ems comes in to sit and see what goes on in the 911 center...it will be good for all of us here in Pennsylvania Wyoming County.

ABSOLUTELY!!! There is nothing I hate more than the "Them against Us" mentality in emergecny/public service. I everyone is this field learns to respect each others abilities and functions and sympathise with issues that they must deal with to help others then the better we will all do our jobs. IMHO. I just wish that I had slightly more skilled dispatchers in my world.