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Epi-Pens: Discussion


Richard B the EMT

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All EMT-Basics in the US are taught the signs & symptoms of shock & how to treat it. They are also taught how to assist patients with their own life saving medications. If an EMT can assist a patient with his or her own medications then why should they not be allowed to carry & administer those same medications during a life threatening emergencies when ALS is not available?

Simple.....

A pt experiences an illness. Let's say, stable Angina.

Dr. goes to school for 8+ whatever years.

Dr. gives Pt prescription based on years of education, combined with knowledge of up to date trends in treating said illnesses.

Pt goes home and has angina attack.

Pt gets scared and calls EMS.

EMT-B shows up and applies his/her 3 weeks of education to the situation and assists pt with thier Rx med still under the physicians licence and direction.

When put in this context, does it not seem silly to take the physician out of the equasion?

I know I don't want a undereducated Med happy EMT spraying Nitro under my tongue!!

It should also be noted that EMT-B for the most part do not aquire 12 leads, or provide IV therapy either, both of which are the standard of care with Nitro.

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All EMT-Basics in the US are taught the signs & symptoms of shock & how to treat it. They are also taught how to assist patients with their own life saving medications. If an EMT can assist a patient with his or her own medications then why should they not be allowed to carry & administer those same medications during a life threatening emergencies when ALS is not available?

No

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So you want to give EMT-Bs access to, say, nitro?

I am in favor of giving EMT's access to life saving medications with medical supervision including, but not limited to Activated Charcoal, Albuterol, Aspirin, Epi Pens, Nitro, Oral Glucose, Oxygen & Tylenol.

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Simple.....

A pt experiences an illness. Let's say, stable Angina.

Dr. goes to school for 8+ whatever years.

Dr. gives Pt prescription based on years of education, combined with knowledge of up to date trends in treating said illnesses.

Pt goes home and has angina attack.

Pt gets scared and calls EMS.

EMT-B shows up and applies his/her 3 weeks of education to the situation and assists pt with thier Rx med still under the physicians licence and direction.

When put in this context, does it not seem silly to take the physician out of the equasion?

I know I don't want a undereducated Med happy EMT spraying Nitro under my tongue!!

It should also be noted that EMT-B for the most part do not aquire 12 leads, or provide IV therapy either, both of which are the standard of care with Nitro.

I urge you to carefully read my post again. At no point did I say anything about excluding or eliminating Physician input. If we are going to allow EMT's to use AED's, Blind Insertion Airways ( CBT's, Kings & LMA's ) Medical Direction & review is essential. I am sorry but the simple fact of the matter is that Nitro is self administered by patients around the world everyday for chest pain without 12 lead & without IV access! If a patient with no medical training can administer Nitro then why can't an EMT with medical training administer life saving medications like Epi Pens & Nitro? Explain your rationale!

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I am sorry but the simple fact of the matter is that vicodin is self administered by patients around the world everyday.

Since we're playing the "patients self admin based on prescription" game, why not give EMT-Bs access to PO narcotics as well.

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I am in favor of giving EMT's access to life saving medications with medical supervision including, but not limited to Activated Charcoal, Albuterol, Aspirin, Epi Pens, Nitro, Oral Glucose, Oxygen & Tylenol.

Your wish is granted in numerous states

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Our Basics have the ability to administer the patient's own, in-date Nitro tabs with Medical Control approval. Seems reasonable enough to me. If the doc doesn't like what s/he hears (vitals, patient description of pain/symptoms, pt appearance, history of present illness, etc) s/he can deny the order.

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Our Basics have the ability to administer the patient's own, in-date Nitro tabs with Medical Control approval. Seems reasonable enough to me. If the doc doesn't like what s/he hears (vitals, patient description of pain/symptoms, pt appearance, history of present illness, etc) s/he can deny the order.

Here's a thought, why dont you actually educate the EMTs to use nitro and remove the need to run off and ask "doctor may i?"

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I urge you to carefully read my post again. At no point did I say anything about excluding or eliminating Physician input. If we are going to allow EMT's to use AED's, Blind Insertion Airways ( CBT's, Kings & LMA's ) Medical Direction & review is essential. I am sorry but the simple fact of the matter is that Nitro is self administered by patients around the world everyday for chest pain without 12 lead & without IV access! If a patient with no medical training can administer Nitro then why can't an EMT with medical training administer life saving medications like Epi Pens & Nitro? Explain your rationale!

Because those pt's who self administer have prescriptions from a physician.

A physician has assessed, diagnosed, and prescribed.

I understand you are saying, the EMT-B should be allowed to do the same in the absence of a prescription. That is what I disagree with.

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Here's a thought, why dont you actually educate the EMTs to use nitro and remove the need to run off and ask "doctor may i?"

As I am sure you are aware here in the US we have a complex medico-legal system, EMT's & Paramedics do not practice independently, but act as Physician Extenders working under a Medical Director/ Physician's licensure. EMT's & Paramedics do not run off & ask doctor may I, but instead consult with Medical Command regarding the best treatment for patients.

Because those pt's who self administer have prescriptions from a physician.

A physician has assessed, diagnosed, and prescribed.

I understand you are saying, the EMT-B should be allowed to do the same in the absence of a prescription. That is what I disagree with.

Ok, but why do you disagree? If an EMT and/or Paramedic is working under a Physician's licensure acting as the eyes & ears of the Physician in the field & assess a patient & relays that information to the Medical Command Physician and the Physician issues a Verbal Medication Order to the EMT and/or Paramedic based upon the assessment is that not the same thing as a prescription?

Edited by 1EMT-P
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