What should first responders do for a patient?

[DrParasite]

By first responder, I mean the non-transporting hose draggers mostly....

So I was in EMS con ed last night for cardiac arrest management, and one of the topics mentioned was how the medical director doesn't let FD do much in this county, and I brought up my dream that I wish FD first responders could give IM zofram, which would make patient's feel better (and wide QT is exceptionally rare prehospitally).

one of the other attendee (who was a retired deputy director of the county EMS agency) said "Zofran isn't even considered in the first 10 minutes of ALS treatment, and won't help improve mortality, so why should first responders be giving it?"

While a valid point, it got me thinking: "should first responders only be done stuff that might save a person's life, or should they also be doing things that will make their patient's feel much better?

 

[mgr22]

Lots of variables with first responders, but I think all responders should be trying to help patients feel better even if that's all they can do.

 

[CCCSD]

Hold their hand and let them know they are being cared for.

 

[Jim37F]

Well, as an aforementioned non-transporting hose dragger lol, from the BLS side, talking more specifically about interventions and skills (beyond general care/compassion as mentioned above), I would like the ability to check Blood Glucose levels (there's def been more than a few calls where we're standing around on scene with a diabetic, altered patient, strongly suspecting of low blood sugar..... and can't do anything more than take another blood pressure while waiting for EMS....) Sure, sometimes the patient is at home and there's a family member who can go ahead and use their at home meter to check, and we can encourage drinking of orange juice (for the patients who are still able to do so safely), but not every diabetic Pt we encounter is at home with that support system in place....

I would say that's actually a more common scenario than a trauma injury where I wish we had something a little more than an ice pack for pain control... Which is really the only other intervention side I would wish we could do as a BLS provider that we don't have/have an option for.

 

[DrParasite]

I would like the ability to check Blood Glucose levels (there's def been more than a few calls where we're standing around on scene with a diabetic, altered patient, strongly suspecting of low blood sugar.....

honestly, that was one of the things that I couldn't do in NJ, but could do in NC... more than one CVA transport was slowed down waiting for ALS to do a BGL stick.

I would say that's actually a more common scenario than a trauma injury where I wish we had something a little more than an ice pack for pain control... Which is really the only other intervention side I would wish we could do as a BLS provider that we don't have/have an option for.

and we can also give OTC Tylenol and Advil PO for pain management....

I figure if you can give epi IM, than you can do the same for Zofran.

As someone who end up vomiting after being first due to structure fire (lesson learned: don't go to a fancy steakhouse before a shift), IM Zofran is awesome!!!

 

[johnrsemt]

When I worked in Indianapolis a Basic asked our medical director during a class why Basics weren't allowed do more: there were 5 Basics in the class that day. The Medical Director asked them what they could do for Cardiac type chest pain patients and it 4 of the 5 couldn't write down all the things that they were allowed to do for cardiac chest pain patients: Aspirin, O2 (if needed), assist with patient NTG, cardiac monitor (placed not interpreted), and transport.
Medical Director said that is why Basics aren't allowed to do more.
Over the next 2 years, he added blood glucose monitors, (oral glucose was already allowed, better to give glucose to patients that have high glucose, than not give it to those that have low glucose), and clearing C-spine in the field. But still few basics would do them