Stoker

Absolutely not. Not in my nation. As an emergency, last ditch effort in a paediatric population, I can almost go for it. As was already mentioned, the worst you are going to do is tach the kid out a bit. But in an adult population, there is way, way, way too much room for catastrophic error by an ambulance driver with one hour of "training" on allergic reactions. It's hard enough for a paramedic or even a physician to tell the difference between a heart attack and anaphylaxis without the benefit of diagnostic tools. And if you go giving epi to an AMI because the signs matched up with your cookbook, you're likely to kill somebody.

No way.

So the presence of urticaria, tissue swelling and respiratory distress, +/- gastrointestinal symptoms compared to AMI signs and symptoms is difficult for even a physician to tell the difference between? There are exceptions to the rule, but surely those cases are few and far between. Do the benefits outweigh the risks? I believe they do. If educators can't provide enough education to BLS on recognition of S+S of anaphylaxis and when to implement a prepared, pre measured dose of adrenaline, then maybe that's the issue that should be looked at. Or is the issue really protection of ALS skills and apprehension that dissemination of those skills will mean loss of recognition/pay?

Wow. It's well after midnight here and this little Aussie is still up reading and wondering how the original subject turned into a "Zippy UK St John He Said She Said"series. Careful now, remember to keep your words soft and sweet just in case you have to eat them... oh, and the horse was a nice touch.. :wink:

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I couldn't agree with you more. Is this just an american thing or do paramedics in countries outside of the states also run codes like this?

From an Aussie perspective, this topic is really interesting. It depends on which state in Australia you work, but in Victoria we have a policy that allows for us to "call" patients after 30 minutes of ALS care (the majority of our staff are ALS). It's a very rare occasion when a patient with no ROSC is loaded and transported.

In rural areas, running an arrest on your own isn't as uncommon as we would like it to be, in which case the focus is on good CPR and defib rather than drugs that lack evidence based research to suggest they make a difference to patient outcome.[fade]