What are you allowed to do?

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clibb

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What does your Medical Director allow you to do?

I work on ALS rigs as an EMT-B. I'm allowed to do all the basic medications such as Epinephrine, Glucose, ASA, Nitro, Oxygen, but we do not carry Acti-dose. As an IV certified EMT I'm also allowed to push D10, D25, and D50. Also in narcotic overdoses I'm allowed to push Narcan which is freaking sweet. Just recently we got extra training in King Tube intubation, so we are allowed to do that.
Plus any ALS assist that the Paramedic asks us to do.

How about you guys?
 
Considering most of my past experinces with narcan, I disagree with how "freaking sweet" administering it is...
 
Anything my med control wants me to.
 
Hehe. We had a medic give narcan once for OD. Later, we heard him giving report. Pt was restrained, medic said he thought they'd be boxing. Then cutting out we heard, "Yep, we're gonna be boxing..." This came over the radio at the station while my basic class was in the next room.
 
In NM:
The following plus general FR skills like 02, CBG, splinting, etc...
a. Allowable Skills:
1. Mechanical positive pressure ventilation.
2. Use of multi-lumen, supraglottic, and laryngeal airway devices (examples:
PTLA, Combi-tube, King Airway, LMA)
3. Pneumatic anti-shock garment
4. Application and use of semi-automatic defibrillators
5. Acupressure
6. Transport of patients with nasogastric tubes, urinary catheters, heparin/saline
locks, PEG tubes, or vascular access devices intended for outpatient use
b. Administration of approved medications via the following routes:
1. Nebulized inhalation
2. Subcutaneous
3. Intramuscular
4. Intranasal
5. Oral (PO)
c. Allowable Drugs
1. Oral glucose preparations
2. Aspirin PO for adults with suspected cardiac chest pain
3. Activated charcoal PO
4. Acetaminophen PO in pediatric patients with fever
5. IM auto-injection of the following agents for treatment of chemical and/or nerve
agent exposure:
a. atropine
b. pralidoxime
6. Albuterol (including isomers), via inhaled administration
7. Ipratropium, via inhaled administration, in combination with or after albuterol
administration
8. Epinephrine via auto-injection device
9. Administration of naloxone by SQ, IM, or IN route
10. Administration of Epinephrine, 1:1000, no single dose greater than 0.3 ml,
subcutaneous or intramuscular injection with a pre-measured syringe or 0.3 ml
TB syringe for anaphylaxis or status asthmaticus refractory to other treatments
under on-line medical control. When on-line medical control is unavailable,
administration is allowed under off-line medical control if the licensed provider
is working under medical direction using approved written medical protocols.

As an EMT-B IV/ECG in CO I could do similar to the OP. Never was a basic here in TX, but like Linuss said, anything the medical director says you can do.
 
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usalsfyre said:
Considering most of my past experinces with narcan, I disagree with how "freaking sweet" administering it is...
Click to expand...

O okay, then we disagree.

I totally forgot Albuterol. We are allowed to administer that. OPA and NPA.
 
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My medical director is Dr. Kevorkian, so I can do everything. I can high-five people out of cardiac arrest, I can shock asystole, and about everything else you have seen on your favorite medical show.
 
clibb said:
O okay, then we disagree.
Click to expand...

Just a word of advice, "consciousness" is not a good end point goal of Narcan administration.

As Linuss and jt noted, Texas is an incredibly odd state regarding scope. Due to the delegated practice act, if a medical director want his ECAs (equivilent to a FR) doing open thoracotomies and cardiac massage, he's allowed to as long as he "adaquately trains" them. (Cant you see that CE. "After making the first inscion, you place the rib spreaders..."
 
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Medication wise i could adminster patients OWN epipen, nitro, inhaler. 5 Rights have to all be in place. And i could give glucose and charcoal. Thats it.
 
lampnyter said:
Medication wise i could adminster patients OWN epipen, nitro, inhaler. 5 Rights have to all be in place. And i could give glucose and charcoal. Thats it.
Click to expand...

Safe to assume O2 and ASA as well?

Same here, but random side note, my private carries charcoal. County 911 does not. Director says he won't waste money on it.
 
usalsfyre said:
Considering most of my past experinces with narcan, I disagree with how "freaking sweet" administering it is...
Click to expand...

Yea, same here. The first time I saw it used, it was used improperly. I saw a cop get covered in puke, and I got involved in a wrestling match with the pt, another cop and a firefighter on the puke and urine soaked carpet.

TITRATE!!! Only till they start to breathe spontaneously at an adequate rate. Not very cool in my opinion, but neither is FIVP Narcan.

So maybe I disagree with you as well.
 
Never understood why people want to bother waking up a narc OD patient... Just get the RR up to normal or just bag them all the way to the hospital. It's not freaking rocket science. Just cause you CAN give the drug, doesn't mean you should.
 
jtpaintball70 said:
Never understood why people want to bother waking up a narc OD patient... Just get the RR up to normal or just bag them all the way to the hospital. It's not freaking rocket science. Just cause you CAN give the drug, doesn't mean you should.
Click to expand...

Because it's apparently "freaking sweet" don't ya know :ph34r: .
 
[YOUTUBE]http://www.youtube.com/watch?v=8xU_vcb3kso[/YOUTUBE]

Narcan is friggen sweet!
 
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