NBPCP

4 hours ago, paramedicmike said:

Does it increase prehospital survival rates?  What does the research show?  Go do some reading.

I have been.  Don't think online forums is might only source of information.

4 hours ago, paramedicmike said:

You're upset about something.

That's a little presumptuous, this is in response to a CBC national investigative report on the different levels of care you may get when you call 911.  Part of the debate focused on a patient who didn't receive Nitro because a Primary Care crew could not give Nitro, due to no prior hx by the pt and the crew not being IV certified.  So a number of us are asking, should Nitro be given more importance in prehospital settings and is this a shared theme across different EMS jurisdictions to downplay the efficacy of Nitro?  With your training, experience, do you think Nitro increases survival rates, in the 'microcosm' of prehospital emergency care?

11 hours ago, paramedicmike said:

I don't see the problem with the Q&A as listed above.  It seems pretty straight forward.  In that light I'll have to ask what, exactly, are you wondering? 

basically does it increase prehospital survival rates like ASA?  My argument is yes it does, any drug that dilates the coronary vessels, increases cardiac perfusion and workload of the heart like OFF Load stated, should be given more importance than our governing body seems to be giving it.  Another reason why we can't give Nitro unless the BP is above 100 sys or the pt has prior use, even in light of studies have shown there to be little adverse reactions to administering Nitro to these patients, is because it is argued by some that it is not a life saving drug or that it has any therapeutic effects beyond pain control worthy enough to offset the small risk in these contraindicated patients.

here are a few FAQ quotes from our medical director who is a physician, whose license we practice under.  Again this seems to be a reoccurring theme in correspondence from our governing body that less emphasis should be put on Nitro as it is merely symptom 'pain' relief drug...

Question: Are Advanced Care Paramedics expected to perform 15 Lead ECG’s in the field to

rule in/out RVI?

Answer: Not necessarily. Many variables may be present affecting any Paramedic’s ability to

complete certain tasks. The presence of an inferior STEMI alone is enough to support

withholding NTG.

REMEMBER: Nitroglycerin is a “Symptom Relief” drug….not a “Life Saving” drug. ASA is the only

medication in your arsenal that has been proven to improve survival from myocardial

infarctions.

Question: Really? PCPs shouldn’t patch with a BHP for patients with no previous use of

Nitroglycerin and no IV?

Answer: Yes. Again, NTG is a “Symptom Relief” medication only. The Medical Directives are clear

that if a patient does not meet the conditions they should not receive the medication or

treatment.

. 

I hear this all the time, nitro is just for pain, there is no therapeutic value, it doesn't save lives.  Going back to first year anatomy, why wouldn't a medication that dilates the coronary arteries therefore increasing perfusion of the heart leading to less tissue necrosis, and ultimately less strain on the heart, not have a therapeutic value?

Does anyone have medics in their service who wear ribbons with their work uniform, ex. ex military ribbons, St. John ribbons or GG decorations. Is this a customary pratice? Of course in formal situations like funerals, but while on duty? Ive seen a few Municipal Police Officers wearing ribbons while on duty.

Im from Ottawa, had a buddy work for them after he graduated since there were about 1 job for every 50 graduates. Good way to pay off tuition though while going to school. How is it looking this spring, lot of retirees?