bigbaldguy
Former medic seven years 911 service in houston
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We have king tubes. Not sure if we will be getting more comprehensive kits now that we will be flying over water.
the 100% directionless thread
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We have king tubes. Not sure if we will be getting more comprehensive kits now that we will be flying over water.
EpiEMS
Forum Deputy Chief
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Was just doing some flying around for interviews (yay, graduation...), and I was pleasantly surprised to see that there were pretty extensive med kits and AEDs even on small commuter planes. Not that I had to use one (or would hope to), but it's nice that they're there...
Achilles
Forum Moron
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I was unaware of that. I thought the kit only included NPA, OPA.
here is the list of everything....
http://rgl.faa.gov/Regulatory_and_G...6A65006505A2?OpenDocument&Highlight=first aid
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lightsandsirens5
Forum Deputy Chief
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True that. Though one of then is that exact situation right now.
I suppose I should stop complaining. At least I have an awesome job, I'm alive, you know....stuff like that.
NomadicMedic
I know a guy who knows a guy.
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Peanut allergy
Epi 1:1000.
lightsandsirens5
Forum Deputy Chief
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And Benadryl. Either that or lots and lots of Epi.
Anjel
Forum Angel
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Curious. Do you guys wait for an IV to give all your drugs for anaphylaxis? Or do you give everything IM? Besides the sQ Epi.
Clare
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Adrenaline for anaphylaxis should be not be given subcutaneously; absorption is poor to variable and takes much longer than intramuscular administration.
IM adrenaline is the standard treatment here and we are not shy about giving it if it is thought the patient needs it; history of myocardial infarction or angina (myocardial ischaemia) should be reason enough for a reduced dose, say 0.3 mg instead of the standard 0.5 mg.
Intensive Care Paramedic has IV adrenaline and I am not an ICP so I don't know, it depends how quickly you can get an IV into somebody especially if they are very sick and shut down it might take a little bit whereas its fairly quick to draw up some IM adrenaline and give that, you can always give an infusion of IV adrenaline if needed. If you can get a drip in quite quickly then you could just go straight to an IV infusion I suppose.
Aidey
Community Leader Emeritus
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We give IM epi here. I usually try and give the Epi IM, have someone start a neb while the line is being started and give the benadryl IV.
Aidey
Community Leader Emeritus
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Before you start telling us what we should and should not do, you should make sure that SQ epi hasn't been the standard in the US for a very long time. It is only in the last couple of years that IM epi has been accepted for pre-hospital use. :glare:
Clare
Forum Asst. Chief
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You are free to do what you like, not for me to make that decision, however there is now a strong consensus amongst international guidelines (particularly the NICE guidance from the UK) that IM adrenaline is much better absorbed, much faster than subcutaneous adrenaline.
It was recently asked why we do not carry promethazine or another anti-histamine or steroids (e.g. dexamethasone) for anaphylaxis and the answer came back that there is no evidence they are beneficial. We now carry oral loratadine for patients who have minor allergy (skin rash or itching) so that we can give it to them and leave them at home.
Aidey
Community Leader Emeritus
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There is also a strong consensus that backboards are crap, but we still have to use them. Unfortunately we (the end users) are not in control of these things in the US and it is extremely insulting to be talked down to by international providers who were taught differently than our current practices. We know some of the stuff we do is not current with international guidelines, but we still have to follow our protocols.
Clare
Forum Asst. Chief
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I can't say I know about backboards; never used them so I've never had occasion to look into the matter so it's not for me to comment.
I wasn't talking down to you, all I said was that adrenaline should not be given subcutaneously; the exact same thing could be said for giving adrenaline transdermal or giving intramuscular morphine to children. I wasn't saying anything about you, but rather what about what was suggested and if you take exception to that then I apologise, it was not my intention.
Actually it's probably pushing a decade that IM epi has been ok. Could be wrong though...might be even longer.
Clear something up for me if you don't mind. Are you saying that, despite medicine changing quite often, people should not tell someone who was taught to use the old, incorrect method of doing something that they are wrong and should be using the new, correct method?
I'm going to have to remember you said that.
medic417
The Truth Provider
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Since the mods are failing to do the job I guess I'll have to say it. TIME TO GET BACK OFF TOPIC PEOPLE.
Your airline still hands out free peanuts!? :blink: :beerchug:Peanut allergy
Achilles
Forum Moron
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Aidey
Community Leader Emeritus
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In some of the more progressive areas it might be 10 years. In the last 9 years I've worked under 7 different sets of protocols in 3 states and they all still had SQ initially. 2 of them were updated while I was working under the protocols. I'm not sure if any have changed in the years since I stopped using them. There are definitely still places in which SQ is the only accepted route of administration.
I have nothing wrong with discussing changes in medicine and advocating for improved protocols. I have a problem with people talking down to providers who are stuck using outdated protocols, especially when those providers know they are outdated. Most US paramedics don't have the luxury of being able so say "oh, this other way is better, I'll just start doing that instead".
There is a huge difference between an educational discussion and someone going around saying "you're doing it wrong".
Wanna talk about guns?
Itching to do some more IDPA shooting, just haven't been able to with my schedule. Actually, I really want to do a 3 gun match as I haven't been able to use my AR in that sort of environment yet.
Well the first time I can remember seeing it was 7 or so years ago. Figure that where I was working then wouldn't be likely to be the first place to do it and I'd say it's a good bet that 10 years or more is about the right timeframe. If we're just going to base this on personal experience anyway. Either way, doing something that you have to even though you know there is a better way is different than doing something and not knowing there's a better way. Hard to tell which it is unless someone explains themself.
Regardless, saying something like:
is definetly out of line. What should probably have been done was to tell them they're wrong and then tell them why it's wrong.
I'll just go back to lurking again in this thead...