"Allergic reaction? Call an ambulance" says CNN

[daedalus]

Capes advises people who experience a systemic reaction to call 911 and wait for an ambulance, because it will have medicine to treat the reaction immediately. An antihistamine such as Benadryl will be given and, in severe cases, a shot of epinephrine.

http://www.cnn.com/2009/HEALTH/08/1...r.bee.wasp.stings/index.html?iref=mpstoryview

We all know this to be false. Do you see how a lot of America is fooled into believing that most ambulances are staffed by paramedics? Do you think this is fair to the public?

 

[HotelCo]

Would you rather they just sit at home and do nothing? It's about getting them care, whether that means on-scene by paramedics, by EMTs with Epi-Pens, or by BillyBob from down the street, driving fast to the hospital.

Obviously an ambulance would be preferred, even if they didn't have any medications available.

 

[daedalus]

Would you rather they just sit at home and do nothing? It's about getting them care, whether that means on-scene by paramedics, by EMTs with Epi-Pens, or by BillyBob from down the street, driving fast to the hospital.

Obviously an ambulance would be preferred, even if they didn't have any medications available.

I did not say I would rather anything over what CNN was suggesting. I was not and am not making any sort of comment on the debate of using an ambulance in this situation (be it an ALS or BLS rig). I bolded one part of the article to point out that the public believes that most ambulances are able to provide advanced care, when in reality, a whole lot of them are not able too.

 

[HotelCo]

Before I got into this I knew that an ambulance was more capable to handle my emergency than I was. That was good enough for me.

 

[TransportJockey]

Here in NM the advice does work because even at the basic level we can administer SQ or IM Epi 1:1000 (BLS is allowed to administer with auto-injectors or self limiting syringes [0.3ml syringes]). ILS is limited to the same but could use 0.3mg 1:10,000 IV with MCEP approval. Epi at the BLS/ILS level is generally an MCEP call either way, but it can be justified with no call if there wasn't time to call before administering the drug

 

[Melclin]

Why is it a problem that the public thinks you are all capable of care that some of you cannot provide? It's better than the other way around and have them not call you because the don't know whether or not you can help.

It doesn't change their suggested course of action: call 911, let us sort it out.

 

[MrBrown]

Why is it a problem that the public thinks you are all capable of care that some of you cannot provide? It's better than the other way around and have them not call you because the don't know whether or not you can help.

It doesn't change their suggested course of action: call 911, let us sort it out.

Couldn't agree more mate; everybody thinks everbody is capable of everything which we know is simply not the case!

 

[medic417]

Why is it a problem that the public thinks you are all capable of care that some of you cannot provide? It's better than the other way around and have them not call you because the don't know whether or not you can help.

It doesn't change their suggested course of action: call 911, let us sort it out.

Because it gives a false sense of security. If something happens I'll dial 911 and they will make me better. So they wait 5-10 minutes and only a basic level crew shows up, takes 10 minutes loading and doing vitals, and all they can do is drive the 10-15 minutes to the hospital. Patients drops dead during final 5 minutes of transport because they did not get the medicine patient needed that a Paramedic could give. It would have been better for family to immediately loaded and transported as they would have reached hospital before the basic crew was even ready to begin transporting and hospital would have hopefully gotten the meds in time for them.

The public needs to be educated that patient care is not equal at all levels. Honestly city's/towns/communities/counties should have to post an ad every day that lists what level of patient care is available.

 

[Sasha]

http://www.cnn.com/2009/HEALTH/08/1...r.bee.wasp.stings/index.html?iref=mpstoryview

We all know this to be false. Do you see how a lot of America is fooled into believing that most ambulances are staffed by paramedics? Do you think this is fair to the public?

No, I don't think it's fair. I think it gives them a false sense of security. If they live within 10-15 minutes to the hospital, it may actually be faster for them to just drive themselves to definitive care, however if they think they can get treatment enroute, why would you drive yourself?

I think the public should be educated to what is really available to their areas and what each level does. Not just "This area has basic EMTs." But "This area has basic EMTs, they are not capable of invasive procedures except for a combitube. They cannot control your pain, they can not provide drug interventions for your medical emergency."

 

[spisco85]

Am I spoiled at my agency? As a basic I can administer non-prescribed epi-pens to patients in anaphylaxis, can get a medic while loading the patient in under five minutes if I'm on a BLS or ILS ambulance, only have a 2-15 minutes drive to the hospital depending where we are coming from and how we are getting there, and I don't need to contact online medical direction for over 95% of my treatments.

 

[TransportJockey]

Am I spoiled at my agency? As a basic I can administer non-prescribed epi-pens to patients in anaphylaxis, can get a medic while loading the patient in under five minutes if I'm on a BLS or ILS ambulance, only have a 2-15 minutes drive to the hospital depending where we are coming from and how we are getting there, and I don't need to contact online medical direction for over 95% of my treatments.

Sounds like NM EMT-Bs... way too much scope for so little training.

 

[Shishkabob]

Huh? How is an Epi-pen "too much scope"?

Amber can correct me if I'm wrong (I'm in a sleep deprived stupor) but I can't think of a single thing here that we basics have to call in for. By "here" I mean AMR Dallas.

 

[Sasha]

Sounds like NM EMT-Bs... way too much scope for so little training.

Amen brother!

 

[ResTech]

Epi-Pens aren't too much for a basic... in PA we have em as primary use onboard the units. Before an EMT can administer, they have to call medical command. Anaphylaxis is a condition where a patient needs epi NOW and not 20 minutes later when ALS arrives. Not all areas are blessed to have Paramedic ambulances.

Some areas still run an out dated two-tier response system.

 

[spisco85]

Really? Too much scope? How is that too much scope? Please explain.

 

[MrBrown]

Really? Too much scope? How is that too much scope? Please explain.

Beucase in the US it seems you guy's aren't taught jack or trusted to do anything without scurrying off and asking "mother may I?". Granted I have seen some systems which have a simmilar level of autonomy as here but that is the exception rather than the rule; I know some of my friends in the US have to call up for morphine for frick sakes!

Now our system is hardly superior in many regards but one thing I will jump up on the soapbox about is that in the last decade we've made some fairly big advances in education and scope of practice.

This is why I am so dissapointed with the EMS Agenda for the Future when it is compared to places like Canada, the UK and Australia. The National Scope of Practice Model still (and I quote) says that EMT and AEMT will be given those skills that can be performed with "limited training".

The only real changes to the scopes of practice are as follows:

EMT - ASA & glucose PO (but no BGL measure - huh??)
AEMT - GTN SL, adrenaline IM, glucagon, IV glucose, naloxone, salbutamol, entonox

All of the skills listed above can be performed by what is analogoue to a "basic EMT" in Canada and New Zealand (except naloxone) and all of them can be performed in Australia (graduate paramedics).

I know it's about more than "I can do what you can't" and that you have to look beyond the scope of practice which is just the final manifestation of a lot of other issues but it's a bit sad really.

 

[HotelCo]

Beucase in the US it seems you guy's aren't taught jack or trusted to do anything without scurrying off and asking "mother may I?". Granted I have seen some systems which have a simmilar level of autonomy as here but that is the exception rather than the rule; I know some of my friends in the US have to call up for morphine for frick sakes!

Now our system is hardly superior in many regards but one thing I will jump up on the soapbox about is that in the last decade we've made some fairly big advances in education and scope of practice.

This is why I am so dissapointed with the EMS Agenda for the Future when it is compared to places like Canada, the UK and Australia. The National Scope of Practice Model still (and I quote) says that EMT and AEMT will be given those skills that can be performed with "limited training".

The only real changes to the scopes of practice are as follows:

EMT - ASA & glucose PO (but no BGL measure - huh??)
AEMT - GTN SL, adrenaline IM, glucagon, IV glucose, naloxone, salbutamol, entonox

All of the skills listed above can be performed by what is analogoue to a "basic EMT" in Canada and New Zealand (except naloxone) and all of them can be performed in Australia (graduate paramedics).

I know it's about more than "I can do what you can't" and that you have to look beyond the scope of practice which is just the final manifestation of a lot of other issues but it's a bit sad really.

Depends on where you go in the US. It's all up to the Medical Director.

 

[Shishkabob]

Exactly.


ASA, Epi-pens and oral glucose is the norm around here.

 

[ffemt8978]

Exactly.


ASA, Epi-pens and oral glucose is the norm around here.

In Washington, every ambulance is required by law to have Epi-pens on board, and every EMT can administer them if necessary...It's called the Kristine Kastner Act. Feel free to google it if you want.

 

[dmc2007]

Exactly.


ASA, Epi-pens and oral glucose is the norm around here.

Same here. The protocol varies slightly from agency to agency, but every BLS in the county carries them assuming I understand it correctly.