the 100% directionless thread

[JDub]

What drugs do you have ampules for on the ambulance?

An ampule (ampoule) is a type of vial that is designed to protect the contents from exposure. As such, it is hermetically sealed and normally has inert gas inside. The top needs to be cracked off.

There are most definitely single dose vials...

This would make more sense. I just hate if my medic asks me to draw up a medication and it is an ampule. It just seems to take more work and complicate things by having more sharps laying around.

Plus I don't know how much of a real concern it is, but we don't carry any filtered needles to draw out of an ampule with.

 

[bigbaldguy]

This would make more sense. I just hate if my medic asks me to draw up a medication and it is an ampule. It just seems to take more work and complicate things by having more sharps laying around.

Plus I don't know how much of a real concern it is, but we don't carry any filtered needles to draw out of an ampule with.

I still think its more of a cost issue than anything. Ampules are a pain. We recently started seeing them on the truck because of the drug shortage.

 

[silver]

This would make more sense. I just hate if my medic asks me to draw up a medication and it is an ampule. It just seems to take more work and complicate things by having more sharps laying around.

Plus I don't know how much of a real concern it is, but we don't carry any filtered needles to draw out of an ampule with.

Btw you shouldn't be drawing up medications. Additionally, you should be using a filter...May not hurt the patient tomorrow or ever (for you), but its just poor practice.

SHFD, yeah thats the only drug I thought an ambulance might have, though they do make multi dose vials of epi 1:1000

edit: I guess before I jump to conclusions about what you should and shouldn't do. I guess it depends where you are. I think Washington allows EMTs to give IM epi. However, even if it was legal in your state to draw it up I would not feel comfortable having someone else draw that medication up.

 

[Handsome Robb]

Only one we still have in ampule is Epi 1:1000.

Well this was an easy OT shift. And our EMTB student did great with a pediatric trauma call earlier. Didnt hesitate to do an assessment and ask what she could do.

Same here, also D10 but they stopped buying them so they are slowly disappearing as they expire.

I love students like that!

 

[Tigger]

Only one we still have in ampule is Epi 1:1000.

Well this was an easy OT shift. And our EMTB student did great with a pediatric trauma call earlier. Didnt hesitate to do an assessment and ask what she could do.

The last call I did for my basic clinicals was for a six year old punched in the face by an angry non-family adult. I got through it all and the fire medic precepting me gave a thumbs up and I finally realized that I could definitely hack this on my own. I don't remember a whole lot else from class, but that'll stay with me.

 

[shfd739]

The last call I did for my basic clinicals was for a six year old punched in the face by an angry non-family adult. I got through it all and the fire medic precepting me gave a thumbs up and I finally realized that I could definitely hack this on my own. I don't remember a whole lot else from class, but that'll stay with me.

That's awesome. All it takes is that little confidence reinforcement to make us realize we got this.

Ours was a 4 year old hit by a car. This girl didn't hesitate to jump in and kept asking what she could do to help me and was asking questions.

I'd take her over my normal partner and some of our current basics.

 

[Clare]

What drugs do you have ampules for on the ambulance?

Glass ampoules

- Adrenaline
- Midazolam 15mg/3ml
- Fentanyl
- Ondansetron
- Ceftriaxone
- Morphine
- Naloxone
- Lignocaine
- Salbutamol
- Ipratropium bromide
- Atropine
- Methoxyflurane
- 0.9% NaCl for injection

Single use vials

- Amiodarone
- Adenosine
- Glucagon
- Ketamine
- Midazolam 5mg/5ml
- Vecuronium dry powder
- Suxamethonium

 

[silver]

Glass ampoules

- Adrenaline
- Midazolam 15mg/3ml
- Fentanyl
- Ondansetron
- Ceftriaxone
- Morphine
- Naloxone
- Lignocaine
- Salbutamol
- Ipratropium bromide
- Atropine
- Methoxyflurane
- 0.9% NaCl for injection

Single use vials

- Amiodarone
- Adenosine
- Glucagon
- Ketamine
- Midazolam 5mg/5ml
- Vecuronium dry powder
- Suxamethonium

Based on some of the naming, you are in Australia or similar country? Also you use methoxyflurane in a ambulance? Thats kinda cool.


In the US, I would say single use vial for many of those are way more common (except like ipratropium, albuterol, now epi 1:1000 etc.).

 

[CANDawg]

Also you use methoxyflurane in a ambulance? Thats kinda cool.

I'm sure you mean besides the liver and kidney damage, of course.

 

[Handsome Robb]

I'm sure you mean besides the liver and kidney damage, of course.

Did I miss something?

I'd love to have the green whistle as an option on the box.

 

[Clare]

Based on some of the naming, you are in Australia or similar country? Also you use methoxyflurane in a ambulance? Thats kinda cool.

In the US, I would say single use vial for many of those are way more common (except like ipratropium, albuterol, now epi 1:1000 etc.).

You might want to be careful about the whole "similar to Australia" part; even girls have been known to do crazy things when provoked

I've never used methoxyflurane and probably never will as the majority of our ambulances carry entonox. Methoxyflurane is only used at rural stations where it's hard to refill entonox cylinders or if one can't be carried for example on the motorbikes.

I made a mistake in the above list; atropine and 0.9% sodiumchloride come in plastic ampoules with snap off tops.

Single use vials are more expensive I think I am not sure.

I'm sure you mean besides the liver and kidney damage, of course.

I've heard about this mentioned in a few places but I have never seen any evidence myself that 3 ml of methoxyflurane (the inhaled ambulance dose) causes any damage?

Methoxyflurane is used almost exclusively in Australia so I suppose it's been considered safe by a number of states there.

It's a pain, while I've never used it I have been trained on it, and I much prefer entonox it is so much simpler and easier and you can use it for more than one patient by changing the filter/mouthpiece. The only upside to methoxyflurane is it's easier to carry which is why it's used in places where entonox is too big and heavy.

 

[Handsome Robb]

Oh geez we have another kiwi on our hands!! I wish we still had nitronox on our street units :\

 

[SSwain]

I hate you!

Its been a long time dream of mine to own a 1911 .45.

Unfortunately in NY, attaining the permit is not worth it. Its $300 and a 6 month waiting period for approval and a whole bunch of hoop jumping. (and it expires every 3 years)

Come to WI...I'll take you out to the range. I reload my own ammo so supply will not be an issue.

Here is some more of my gun porn....

 

[Clare]

Oh geez we have another kiwi on our hands!! I wish we still had nitronox on our street units :\

Hey that's a bit harsh, all things considered we're very nice I assure you.

Why did you get rid of entonox and what do you carry instead?

 

[Handsome Robb]

Hey that's a bit harsh, all things considered we're very nice I assure you.

Why did you get rid of entonox and what do you carry instead?

Sorry, poor attempt at conveying humor, I worked ski patrol and lift ops for a long time, spent a lot of time hanging with New Zealanders. Probably have my favorite attitude of all the walks of life that I've met throughout my few years. Didn't mean to sound harsh, sorry!!

It's impossible to get parts for the portable blenders here in the states. Our ILS special events crews carry it still as well as our ALS Ski Patrollers, they pulled it off the street units just before I got hired. Analgesia wise I have fentanyl IV/IN or Morphine IV, every street unit is ALS. Supposedly we carry acetominophen as well as ibuprofen for BLS/ILS providers but all I've found is liquid oral tylenol and suppositories...no pills to speak of.

Apparently my black cloud decided to replace itself with a late call curse...Did the TEMS PAT on Wednesday and my old preceptor covered my shift that night so I could get a solid night of sleep before the Commander interview yesterday. Today dispatch, because I'm awesome and befriended a dispatcher or three, decides to send me to our only rural post so I could get another solid night of sleep before my Team interview today.

99 times out of 100 you bat zeros out there, it's one of the most coveted posts by the older and/or more burnt out medics. Right around 0230 my partner decides to tell his girlfriend we are pitching a perfect game on the phone...then my favorite dispatcher texts me at 0300 telling me she's going to pull us at 0330 and clear us to go home due to extended driving time because of this storm. 0325 the tones go off for a P1 Chest pain 30 miles in the wrong direction of home...yep I just got home from my shift that is supposed to end at 0430...woulda been cool if it was a STEMI or something other than pleuritic CP secondary to pneumonia that I actually had to manage rather than sit there and list to her sniffle and talk about her 5 kids with different dads for the hour drive to the hospital.

Can I have my black cloud back? At least I was getting off on time when it was around! :rofl:

In other news...who wants to help teach me to iron a shirt for my final interview in 8 hours? Save the smartass comments, my mom did it for me up until I moved out or I just hung them up when they were damp and it worked just fine.

 

[Jon]

Oooooh, I assume you've shot one? 9mm or .40? I like the looks of it (in 9) but I haven't been able to find a shop near me that carries it, so I can't put my booger hooks on it to see how it feels :sad:

9. I'm not a drinker of the 40 short-and-weak cool aid. And no, haven't tried it. Will be hitting up the NRA range on Sunday to test it out. (Yeah, down in VA area this weekend).

 

[Jon]

Come to WI...I'll take you out to the range. I reload my own ammo so supply will not be an issue.

Here is some more of my gun porn....
View attachment 1329

Hey - some of those look familiar. You're the guy that posed in your underwear with guns and guitar hero controllers on your bed, aren't you?

No. Not linking the pic. This is a FAMILY FRIENDLY site. (So don't anyone else do it either).

 

[Jon]

Oh geez we have another kiwi on our hands!! I wish we still had nitronox on our street units :\

I wish someone around here would carry it.

Of course, it has its own issues:

 

[SSwain]

Hey - some of those look familiar. You're the guy that posed in your underwear with guns and guitar hero controllers on your bed, aren't you?

No. Not linking the pic. This is a FAMILY FRIENDLY site. (So don't anyone else do it either).

No...gladly not me. I honestly have not seen the photo you are referring to. Not sure if I want to either.

This is me....for a visual.

 

[Handsome Robb]

I wish someone around here would carry it.

Of course, it has its own issues:

I'm pretty sure that may very well be another reason why it's not on the units. Although it's not hard to get a hold of in the garage. The bottles at least are just sitting in their little container. Now a blender on the other hand might be a bit more difficult to find but they have them somewhere. I've heard lots of stories of shenanigans involving nitrous whether it be abuse or someone opening up a bottle in the back of an ambo and closing it while the crew is inside the ER dropping a patient off. That was long before I was around though.