Simply transporting is completely appropriate when indicated. If that's all you want to do; go for it. In my opinion, It's better to always be doing something while in the back with your Pt instead of sitting still and merely checking vitals every 15 minutes.
When you see your physician for a checkup, do you expect to be prescribed something even if no medication is indicated?
This is the BLS section of the forum, so I'm assuming the poster would be on a BLS truck. Likewise, on a BLS truck the medications wouldn't be available unless tandem is called.
Ok, why not insert a NPA or administer oral glucose or administer activated charcoal?
Good idea. I'm simply saying, in my opinion, doing something is better than nothing.
Why is doing something better than nothing? Since plenty of systems and services charge extra for the administration of oxygen, is causing the patient to have a larger bill (
sometimes significantly larger (.pdf warnng)) worth the provider being able to say, "At least I did something"?
Of course not. I stated O2 because it's a intervention with no side effects in low doses (In a normal, no interventions indicated patient.)
Naloxone isn't going to cause side effects in a patient where it isn't contraindicated and in low doses.
However, let's switch back to EMT level interventions. NPAs don't have any major side effects when placed properly, and if the patient gags, it's easily reversible. Oral glucose and activated charcoal doesn't have any side effects in the doses administered if no contraindication is present. Why not administer those as well?
Why should the side effect profile matter when a drug is not indicated? The side effect of nothing (when indicated) is... wait for it... nothing.
It's situation dependent. Sometimes the simple act of the BLS provider providing an intervention may convince the Pt that it's helping.
Sometimes, it's because of the white lie.
Samuel Hahnemann would be proud.
Because that's what I was taught. It's not because I lack confidence in my interventions; it’s because there's always those situations where your intervention won't have its anticipated effect on the Pt.
I was taught to never make promises in EMS. Saying “this WILL work” is a promise; Murphy’s Law is then begging to make that technician look like a fool.
Fine, hedge the bet with "this should work." Of course saying "oxygen should help" when oxygen isn't indicated is a white lie. A white lie that could add to your patient's bill.
Keep in mind, the original poster asked for our opinions. My entire posts are of my own opinions. I'm not saying it's the absolute best thing to do, I'm saying it what I think is right. If you disagree, then simply don't do what I do.
It's not much of a discussion board if no discussion occurs. Why should
any opinion,
including mine, stand unchallenged if another poster sees reason to challenge it? I am neither infallible, nor afraid of defending my opinion, nor afraid of stating that I'm wrong when I'm wrong. By stating that this is simply your opinion in this manner, what are you afraid of?
I've cared for my Pts this way for the last 2 years, and neither my director nor medical director have told me to stop.
Ask your physician if he administers oxygen for no reason other than he hasn't thought of anything else to do in a patient where supplemental oxygen is not indicated. If he's not afraid of having his patients sit in the ED without supplemental oxygen while waiting for him to initiate treatment (for example, between being brought back and his exam, between his exam and the return of any laboratory tests, or any other delay), than what is EMS afraid of?
How often do you take a patient to the ED on supplemental oxygen only for the receiving RN discontinue oxygen therapy? If a continuous treatment is suddenly discontinued simply because there no longer is a "positive ambulance sign," then shouldn't that be an indication that something is deficient?
I'll end on this note. The absolute worst I've ever felt after handing over a patient to an RN on an emergency call was a patient where I justified placing an NRB because of "protocol." Why did I feel terrible about that?
...because I should be better than that.
EMS should be better than that.
We should be able to, and expected to, defend our interventions, regardless of how minor, based on the patient's condition and the results of our exam. By being unable to justify my intervention, I failed my patient that day. I failed EMS that day. I failed myself that day. Sure, I've had the entire, "Must complete exam before transporting priority patient down the street to the ED" tunnel vision patient, which no doubt had the potential to cause much greater harm than simply administering oxygen when it isn't indicated. However a rookie mistake and a consciously failing to think are two drastically different issues. A rookie mistake is much different to me than saying, "I administered a treatment that I could not justify."
The kicker? The RN didn't say anything negative to me either.
