Dispatch treating CVA with ASA

[mobey]

Hey all I had an interesting experience I thought I would get your opinions on.

I was paged to a 56 y/o male Cx & Alert c/o L sided numbness & chest pain. Came across pager as "Possible CVA/MI".

Upon arrival it was clear this was indeed a CVA but no chest pain present (just numbness). When I asked about Meds pt. stated he had chewed 1 adult Asprin as per 911 calltakers instruction.

It took us about 35min to get to pt. side and his BP was quite elevated, (can't remember exactly but the systolic was over 220). All I could think is oh sure just because he had ASA this will be hemmoragic.

Anyway it was ischemic, and no cardiac event occured, he is now being treated for high BP.

So what do you think should dispatch be giving ASA to chest pain when CVA s&s are present?

Should they be instructing the pt. to take the ASA at any time?

[brentoli]

Our protocols, Powerphone, do not give authorization for any medicine other than an EPIpen. That is the only thing that should be instructed over the phone. I can't take a BP to advise on nitro. I can't do a nuero exam to advise on ASA. But if you tell me he is blue and looks like a blow fish that is an indication I can use for epi on the phone.

[ERDoc]

No one with a possible stroke should be getting ASA until a CT has been done. This means no ASA in the ER, the ambualnce or over the phone.

[JakeEMTP]

IMHO, dispatch has neither the the education or the insight to instruct a caller to do anything, with the exception of starting CPR. Again, without assessing the pt., how can they justify any kind of medication? For all they know, the pt, might have had some indigestion and was on coumadin. :roll: Would ASA be a good choice then considering your long response time? I wish the would just properly dispatch me before trying to do my job.

In this case your pt. turned out ok. What about the next time?

[katbemeEMT-B]

I would take this to your EMS manager as this dispatcher could be a threat to the health of future patients. He or she has no training and even if he did that is not part of their job description. It's performing care outside your scope of practice. If it is not okay for Basics (in some areas) to admin. ASA what makes this dispatcher so special. He/she has no assessment skills and is only suppose to give instruction per the "Oh sh*t what do I do" dispatch instruction book ei: CPR, choking, & eminent birth. The best part is that this will be recorded so there is no way the dispatcher can claim innocence. If something had happened to the patient the family would have come after EMS first, not the dispatcher. Not a stigma you want.

[brentoli]

Sitting through my EMD course was interesting. You can hear quite a few tapes, where the dispatcher is STUPID. And then you can hear the comments in the room and pick which dispatchers in there will be on those tapes in a few years. My favorite was the one telling the woman to stand her asthmatic child up infront of the freezer. Or the dispatcher who wouldn't send an ambulance to a woman who said she was sick and people were passed out. Yeah CO poisoning, 4 people dead.

Dispatch will save your ass better then any EMT-B will. If they are competent.

I like to think I am. Hopefully the guys and girls in the field think so too.

If your dispatch sucks, I hope you carry a cell phone on duty. I hope you have good service too.

[spenac]

Dispatch will save your ass better then any EMT-B will. If they are competent.

I'll take my chances with a basic over any dispatcher, over the phone saving my butt.

[brentoli]

So who is that baisc gonna call when you are both pinned down by gunfire?

[katbemeEMT-B]

That's why our radios have this handy little button we can push and it opens the mike so that the cops can hear everything that is going on. It's what they call the panic button. Oh yeah, you want to take your radio off your belt when you use the restroom as sometimes these buttons accidently get pressed and yep the entire PD hears what's happening. Not me (thank God) but one of our male medics found this out. He still hasn't lived it down. :oops:

[spenac]

So who is that baisc gonna call when you are both pinned down by gunfire?

That happens daily don't it? 99.9% the guy getting me the equipment is more valuable than the guy on the phone. My basics better be shooting back remember I'm in the wild west.

I do think dispatchers that are educated do a beneficial job, getting me where directions to where I need to go and in very rare cases, that get way to much news, they talk somebody through natural childbirth, something that would of happened even if no dispatcher.