Viagra/Nitro Situation?

[paramedicmike]

It's better to add onto an existing thread than create a duplicate, yes. In fact, it is entirely appropriate to do so. It is also entirely appropriate for anyone reviewing an old thread to read the thread in its entirety to gain an understanding of what's already been said before adding new comments. Lately, there seems to be a rash of really old threads being bumped with no new or useful information added.

I'm all for increasing participation in ongoing discussions. But many threads that go years without new posts usually go that long for a reason. Random posts by someone who obviously hasn't read the whole discussion do little to promote ongoing discussion or understanding. Unfortunately, for the newcomer, that is often times a disservice to their learning and understanding of the topic at hand.

The tough part is finding a way to get them to read the entire discussion before posting...

-be safe

Edited April 12, 2010 by paramedicmike

[croaker260]

I am 100% in Dust's corner in this one, although in the past he will often come across as ...well...a self defeating bung hole. (Nuthin' but love Dust, Nuthin' but love)

Administering any drug that has a vasoactive effect on the body is serious business. Its time that we as educators impart the seriousness of the situation on the EMT classess, and divest them of the illusion of safety, give them the same healthy respect for the drugs they should have for speeding code 3, and guns.

Of course some paramedics could learn that same lesson too.

Edited April 12, 2010 by croaker260

[Just Plain Ruff]

I am 100% in Dust's corner in this one, although in the past he will often come across as ...well...a self defeating bung hole. (Nuthin' but love Dust, Nuthin' but love)

Administering any drug that has a vasoactive effect on the body is serious business. Its time that we as educators impart the seriousness of the situation on the EMT classess, and divest them of the illusion of safety, give them the same healthy respect for the drugs they should have for speeding code 3, and guns.

Of course some paramedics could learn that same lesson too.

ok,ok,ok let me ask an obvious question. maybe not too obvious but Im gonna any way.

Why are we allowing basics, who cannot start iv's, who cannot do 12 leads and interpret them to give patients nitro????? Does anyone see the problem here????? or is it just me?

[CBEMT]

It is better to add to old threads with relevant information than to start a new one.

It is OK to to do so.

That's great and all, but I just don't see the point in adding a 2-line post to a 4 year old topic, especially when said post agrees with the majority of the thread.

It's like a brand new Supreme Court Justice writing a one-page concurring opinion to a case that the Court decided years ago.

[Mario1105]

ok as a emt b student who can administer nitro u never give NTG to a pt who is taking Viagra there both vasodialtors you can severely drop ur pts bp or potently kill ur PT NEVER EVER give ur PT ntg if they have had Viagra

note: didnt notice the post was from 06

Edited April 13, 2010 by Mario1105

[Kiwiology]

Why are we allowing basics, who cannot start iv's, who cannot do 12 leads and interpret them to give patients nitro????? Does anyone see the problem here????? or is it just me?

You do raise a valid point and one that has come up here in the past.

GTN used to be restricted to Paramedic or Intensive Care Paramedic because they could infuse fluid and do cardiac monitoring. Oh those were the days .... keep in mind that Ambulance here had been dishing out nitro for at least twenty years before we got 12 lead ECGs.

In the early 2000s the Ambulance Service took GTN and IM Glucagon down to base level and it's been there ever since.

To a point I do agree with what you are saying however I don't think the balance of risk vs benefit is really in favour of once-again restricting GTN, not here at least. Would I want somebody with 120 hour course dishing out nitro .... well that remians to be seen but I am leaning towards no.

Thinking of that another way; do patients do a 12 lead on themselves before they take thier GTN, no.

You don't have to give both squirts of GTN to make up 0.8mg you can always give one of 0.4mg if the patient looks sick or if thier BP is more towards the lower end of the threshold (ours is 100 systolic).

We could argue the same about GTN for an RVI; I had this discussion recently on station over the "no GTN" vs "give the patient some fluid, then give them GTN".

[uglyEMT]

I know here in NJ we do not carry Nitro on our rigs but are allowed as basics to "help administer patient's own nitro" Basically we can help the paitent but his or her own nitro in there mouth. Usually by the time we get there the patient has already had the max 3 doses and the bp is under 100 but still has pains. Thus we are not allowed for several reasons to admin until ALS gets involved. Once ALS is involved they do their magic with IVs and such.

In this case I do beleive it is OK for basics to be allowed to help. I wouldn't want to see basics carrying the nitro and administering to anyone. I know I personally would not feel comfortable administering non physician prescribed meds to anyone. Heck NJ doesn't allow us to give asprin LOL The only drug we are allowed to dispense off-line is Epi. Yes we have a bunch of protocols in place for it before administering. Nine times out of ten the patient has already taken their own Epi-pen and we are watching for a relapse of symptoms and transporting meeting ALS in-route hopefully. If not its 45 min to the ED and we carry 3 pens just in case, but protocol states after the first one we need on-line permission to administer any more.

[ambodriver]

And, as always, minus five for posting an ALS topic in the BLS forum.

also, more reason that B's shouldn't be doing anything with any drugs!