Ridryder 911 Posted May 1, 2006 Share Posted May 1, 2006 The problem again is too many chefs ruin a good stew.. Sorry, we are a specialty already. As patient advocates are we not supposed to want the best for the patient ?.. Can you truly say, having someone with the ability to "push" the meds is the best ?. My daughter can push a syringe full of medicines.. even hook up a monitor, but apparently even EMT's are not aware, that AED' s only monitor 3 rhythms... and those are not the common ones. Seriously, we rather have a half ass system than to actually work on it and have the best ?.. No one can tell me if it is not the best for the patient, then it is purely simply for the ego of the EMT's.. Sorry, you can't interpret ECG, don't know cellular pharmacology, it is short and simple... you are not educated enough to make clinical impressions and administer medications.. that is why we don't allow nurses to do surgery, pharmacist to perform chest tubes.. because they are not educated in those specialties. Really want to push medications? It is simple . go back to school.. pass the boards. then there you go.. The afterward you will see what we were talking about. This is it for me.. this thread is getting boring and will not change anything.. EMT will still be looked upon as uneducated skill seekers.. unfortunately I guess their right. Be safe, R/r 911 Link to comment Share on other sites More sharing options...
JPINFV Posted May 1, 2006 Share Posted May 1, 2006 First and foremost, how long is the Australian basic provider's class. Over in the US, its generally around 120 hours. This includes all the patient assessment, legal information, treatments, etc. There is very little amount of time actually spend on physiology. NTG is basically broken down to "give if they have CP, BP around somewhere above 100 (even the books can't make up their mind), and call medical direction. Of course the ever important "how" of NTG is never discussed. Not everyplace has online medical control for basics, either. So, lets look at what would probably happen. Basic sees patient passed out in house. Basic sees drugs near by. Basic does half assed assessment party because they don't know any better and partly because they just want to do the fun stuff (i.e. push drugs). Basic calls med control, either over simplifies or embellishes the situation and gets order. Basic pushes way too much narcan (because he can, no other reason why). Patient wakes up, beats the crud out of the basic. The driver comes around to see what's happening and gets beaten up too. Patient then crashes after the Narcan wears off. Result, one dead patient, two basics in the local trauma center, basics reverted to being organic vital sign machines that can put patients on oxygen. EMS is about patient care and transport. An EMS system is more progressive by removing procedures that are dangerous, misused, and have little benefit to the patients then by giving their EMTs (P, B, J, what ever letter you may be) what ever toys they demand. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted May 1, 2006 Share Posted May 1, 2006 Basic sees patient passed out in house. Basic sees drugs near by. Basic does half assed assessment party because they don't know any better and partly because they just want to do the fun stuff (i.e. push drugs). Basic calls med control, either over simplifies or embellishes the situation and gets order. Basic pushes way too much narcan (because he can, no other reason why). Patient wakes up, beats the crud out of the basic. The driver comes around to see what's happening and gets beaten up too. Patient then crashes after the Narcan wears off. Huh? Link to comment Share on other sites More sharing options...
LasVegasEMTI Posted May 1, 2006 Share Posted May 1, 2006 4) Nacan admin is generally rare. It is like the whole epi-pen, activated charcoal thing 6) How many times have you seen narcan given? Don't speak for all, here in Las Vegas, we've gotta give it like candy. The opiate use in this town is off the charts. Protocols call for 2mg initial dose, but most of us are intelligent enough to start at a quarter of that and use just enough to get them out of respiratory depression, not completely conscious again. Believe it or not, I also used it twice in my last month in small-town New England... you just never know. Link to comment Share on other sites More sharing options...
nsmedic393 Posted May 1, 2006 Share Posted May 1, 2006 A chimp with the right training could hook up leads to a patient (as long as he wasn't colorblind) and hit the print button. gasp...I know how to attach leads. White, red, green...oh crap, too many colors. I give up. I can trend my patient by reassessment and vitals. If necessary, I can do CPR and I know how to work an AED. Wow, I though the whole point was to try to avoid having to run a code. Link to comment Share on other sites More sharing options...
nsmedic393 Posted May 1, 2006 Share Posted May 1, 2006 Craig. Obviously you work in one of the most progressive systems in the world. Us here in Nova Scotia are particularily looking at you guys and england for new directions. I don't think you would agree thoug that giving a Basic with somewheres around 120-250 hrs of training more drugs makes a system more progressive. It makes a system dangerous. back to the big ol' argument; increase the education then we'el talk. Link to comment Share on other sites More sharing options...
Guest DELETED Posted May 1, 2006 Share Posted May 1, 2006 DELETED Link to comment Share on other sites More sharing options...
PRPGfirerescuetech Posted May 1, 2006 Share Posted May 1, 2006 The problem again is too many chefs ruin a good stew.. Sorry, we are a specialty already. As patient advocates are we not supposed to want the best for the patient ?.. Can you truly say, having someone with the ability to "push" the meds is the best ?. My daughter can push a syringe full of medicines.. even hook up a monitor, but apparently even EMT's are not aware, that AED' s only monitor 3 rhythms... and those are not the common ones. Seriously, we rather have a half ass system than to actually work on it and have the best ?.. No one can tell me if it is not the best for the patient, then it is purely simply for the ego of the EMT's.. Sorry, you can't interpret ECG, don't know cellular pharmacology, it is short and simple... you are not educated enough to make clinical impressions and administer medications.. that is why we don't allow nurses to do surgery, pharmacist to perform chest tubes.. because they are not educated in those specialties. Really want to push medications? It is simple . go back to school.. pass the boards. then there you go.. The afterward you will see what we were talking about. This is it for me.. this thread is getting boring and will not change anything.. EMT will still be looked upon as uneducated skill seekers.. unfortunately I guess their right. Be safe, R/r 911 I agree with everything but one point. I dont think its the ego of EMT's that causes them to believe they should do these skills. IT goes back to another point you made in a prior post. There is a drastic shortage of EMS providers being taught "medicine". These people simply see the skill, its definable simplicity, and what it does, aand want it. None of these people are educated far enough to see the bigger picture. Link to comment Share on other sites More sharing options...
hammerpcp Posted May 2, 2006 Share Posted May 2, 2006 Third, as scaramedic stated, Narcans half-life is MUCH shorter that most opiates. So perhaps in an extreme case, if I'm transporting this terminal cancer patient (come on, let's get away from the stereotypical heroin junkie) who's overdosed on their morphine, purely out of a palliative attempt, and I've maxed out my protocol, I still can ensure proper airway management through intubation. Can you? Again, no, I would not contact BHP for more orders of narcan. To me, if 2 mg isn't having a response on this patient, then there's some other etiology happening, I'm not just gonna keep giving this patient more and more. This is another issue, Narcan (atleast in Ontario) is thought of as a diagnostic aid. If the patient responds to it, you can most likely suspect it was just an overdose. If the patient doesn't ... keep looking. Yes, both Narcan and IV access are good, but not for glorified PCPs. Concerning my logic, that could be a whole other issue not suitable for these forums ... Morphine my friend? No thanks ... I say haloperidol peace um...I thought your example was trying to point out that narcan has a shorter half life then some opiates? Not that the pt had no response........?So why wouldnt you call for more narcan? Link to comment Share on other sites More sharing options...
Lithium Posted May 2, 2006 Share Posted May 2, 2006 Hammer, I think you just proved exactly why BLS personnel should not have access to ALS meds ... If 2 mg of Narcan hasn't shown a response, either every potential receptor is already occupied, or there's something much more serious going on. If that's the case, securing the airway and maintaining adequate ventilations is now my top priority. Not that it wasn't before, but as I previously stated, if I can eliminate the problem, I will. The line of thinking of "well if 2 mg isn't enough, I'll just call for more" is a little skewed. And yes, I do know of patients who've received much more, but that was in-hospital with a lot more resources available. Yes, narcan has a shorter half-life then opiates. However, it is an antagonist, meaning, it will compete for receptor sites. If there's still sites available, it will bind to them, lessening the effects of whatever the patient took essentially by having less receptors for it to bind to and letting the others already bound wear off. Sorry if I'm not making things clear ... peace Link to comment Share on other sites More sharing options...
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