Nitro/BLS

[spenac]

Haven't we beaten this dead horse several times already? :banghead:

:director: The search function is your friend

Doc it seems that search is to complicated, guess another argument for more education prior to certification.

[DwayneEMTP]

Doc it seems that search is to complicated, guess another argument for more education prior to certification.

And this post is more productive than the original how?

Man, I'm just tired of people sniping other's posts for being a waste of O2, with a post that was a BIGGER waste of everyone's time than the original. What's up with that?

And for the record, I guess you better add my name to the remediation list...I can't seem to search for anything here and get less than 100-200 responses. I guess it's too complicated for me as well.

By the way, I have Bio 105,201,202, biochem, psych 101-201, entro to chemistry, sociology, two semester of English, and 40 units of medic school....Are you suggesting that I need "intro to EMT City's search function" before I get my ticket?

[ERDoc]

Dwayne, I will agree with you that continual bashing for something that could have been found with the search funtion is a waste of time, so we should end it here. It is good that the OP is questioning things and looking for more answers and info, but part of being a good student is using all of your resources, including the search.

As for my opinion on the original topic, I do not feel that ntg should be given without an IV line. As others have said, if things go south you need to have an out. You also should not be blindly giving ntg because someone says the magic words, "chest pain." This is where I'm afraid that the "because I have it, I should use it," mentality will come out. Ntg should be given after a good H&P have been done. There are a lot of other things that cause chest pain and do not need ntg. I hate to bring out the old cliche, but 110 hours does not cover all of the things on the differential.

[DwayneEMTP]

Dwayne, I will agree with you that continual bashing for something that could have been found with the search funtion is a waste of time, so we should end it here. It is good that the OP is questioning things and looking for more answers and info, but part of being a good student is using all of your resources, including the search.

As for my opinion on the original topic, I do not feel that ntg should be given without an IV line. As others have said, if things go south you need to have an out. You also should not be blindly giving ntg because someone says the magic words, "chest pain." This is where I'm afraid that the "because I have it, I should use it," mentality will come out. Ntg should be given after a good H&P have been done. There are a lot of other things that cause chest pain and do not need ntg. I hate to bring out the old cliche, but 110 hours does not cover all of the things on the differential.

Sorry Doc, I guess we were typing at the same time or I might have reigned myself in a bit...

I agree with you 100% on every point.

My frustration at the search wasn't really aimed at you alone so much as Spenac's comment after...the combo of the two just got under my skin. There seems to be a tendency lately, by some, to take easy shots at anyone that's not likely to fight back...I guess I might at times go overboard fighting for them.

Apologies to all for grumping.

Dwayne

[EMS828]

in my medical control emt-b, with medical control approval they can with good vs (bp-120 systolic, HR-good and if the patient has taken nitro before, and if ALS is with in 15 minutes.

[DwayneEMTP]

in my medical control emt-b, with medical control approval they can with good vs (bp-120 systolic, HR-good and if the patient has taken nitro before, and if ALS is with in 15 minutes.

Thanks for that...are you a basic? How do you feel about the nitro/IV question?

How do you feel about those protocols?

Welcome to the City!! Thanks for posting!

Dwayne

[Dustdevil]

Think very carefully about the situation we are discussing here.

• 1. Patient experiences chest pain

2. Patient calls for EMS

3. EMT-B or lower arrives

4. Patient has NTG that he has not already taken before your arrival

5. Patient is stable enough to administer NTG to

• Folks, this is the proverbial zebra. It's one of those very rare situations that EMT-Bs lay in bed at night and have a good toss over, but in reality, it just doesn't happen often. When people with diagnosed angina have chest pain, they take their NTG. If it doesn't work, they take it again. This all happens long before any EMTs show up. If they didn't take their NTG, either they don't have it, or else they are disoriented, meaning their vital signs are incompatible with NTG administration. Not that this stops most EMT-Bs from giving it anyhow.

So, one day you actually stumble across one of these zebras, and you immediately pop wood. You squirt your... uh, I mean his NTG under his tongue and think to yourself, "Wow! This is SO cool and SO easy! It's stupid that paramedics think they're the only ones that should do it!" Less than sixty seconds later, your patient goes from a pretty pink to a ashen grey-white colour that you will never, ever in your life forget. He quickly becomes almost completely unconscious. His blood pressure drops too low for you to even palpate. And, to make the experience even more memorable for you, he shits his pants in grand style. You will too, as you see your career pass before your eyes and wonder how you're going to afford the attorney to defend you, even if your patient lives.

An IV makes absolutely no difference whatsoever in the above scenario. So then, what do I want to see from any EMT-Bs that are unlucky enough to have been dispatched on such a run in the first place? Nothing but the tail lights.

[johnbasic]

out in new hamsphire i can help pt with giveing there owen but on teh same hand i will be calling als

[BushyFromOz]

out in new hamsphire i can help pt with giveing there owen but on teh same hand i will be calling als

:shock:

[Scaramedic]

and have a good toss over,

Good toss??

Is that like :jerk: or a :3some:

Peace,

Marty