Protocols You Hate

redundantbassist

redundantbassist

Nefarious Dude
Messages
638
Reaction score
430
Points
63
What are some local protocols you hate, but still have to follow? What would you do to change them?
 
"2-4mg of morphine, then call for additional orders."

Let me manage pain for my patients effectively, with reasonable doses of meds, titrated to effect.
 
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
 
C spine for sure
 
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
 
I check my dosing with the broselow on every pediatric arrest. I do the math myself but will always reference the tape to double check as well as ask for a double check of another paramedic on scene if there's one around. Most pediatric arrests here get a supervisor plus an ALS unit.

Now that I think about it every pediatric arrest I've had except for one I've had a supe with me.

I'm with DE, I hate the fact that pain management has caps on it.
 
Angel said:
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
Click to expand...
So when are u coming to ALCO?
We have all this.
 
  • Like
Reactions: DPM
DEmedic said:
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
Click to expand...
They even print out individual pre-dosed sheets for the babies in the NICU. High stress and specific doses. Broslow and PediStat are wonderful tools.
 
Burritomedic1127 said:
Having only 5mg Versed for intubation with med control orders for combo with Fentanyl......weak
Click to expand...
ImageUploadedByTapatalk1425748025.763405.jpg
 
Angel said:
CSpine protocols
not having a general pain management protocol
having to call base for adenosine, pacing or cardioverting in peds

HAVING to use braslow tape instead of being able to take mom's word for it. (granted if mom isnt sure, then ill use it, but all dosing is based off that tape)

i think thats it
Click to expand...
Ours is worse. We are supposed to use the broslow tape to get an approx weight and then go to our county wide drug sheet, find the color and then the med we want to give. It's a pain in the butt.
 
DEmedic said:
Pedi arrests tend to be the most stressful incidents a paramedic sees. The Broslow tape was designed to eliminate the added stress of trying to determine a weight based medication dose during what is usually a highly emotional incident.

I'd rethink that "Broslow tape hate".
Click to expand...
Have you learned the "handtevy" method for pedi dosages? Takes two seconds to know pedi dosages. The broslow has many issues. Such as the epi dose is the ET tube dose, not IV dose.

Let me know if you want me to explain. It's super easy. And very handy.
 
I learned the Handtevy method at a pedi workshop I took, very quick and easy. I didn't know any EMS systems had switched to it. Has yours?

And yes, you're correct, the Broslowe tape has several issues. Namely it fails to address underweight or obese children, both can impact drug dosages profoundly. But, at the end of the day, both are simply dose estimation tools.

My point was; it's always better to use a dose estimating device (or an app) when you're treating a pediatric patient. Most paramedics underestimate patient weight when asked to provide that weight for a drug dose.

It's not a subject that studied much, but this one is definitely worth a look.
http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1263&context=jephc
 
DEmedic said:
I learned the Handtevy method at a pedi workshop I took, very quick and easy. I didn't know any EMS systems had switched to it. Has yours?

And yes, you're correct, the Broslowe tape has several issues. Namely it fails to address underweight or obese children, both can impact drug dosages profoundly. But, at the end of the day, both are simply dose estimation tools.

My point was; it's always better to use a dose estimating device (or an app) when you're treating a pediatric patient. Most paramedics underestimate patient weight when asked to provide that weight for a drug dose.

It's not a subject that studied much, but this one is definitely worth a look.
http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1263&context=jephc
Click to expand...
Yep we have begun to implement it.
 
COmedic17 said:
Have you learned the "handtevy" method for pedi dosages? Takes two seconds to know pedi dosages. The broslow has many issues. Such as the epi dose is the ET tube dose, not IV dose.

Let me know if you want me to explain. It's super easy. And very handy.
Click to expand...
"HANDY" :)
 
I hate any protocol that includes "contact online medical control for orders." A well trained paramedic should have the discernment to know when he/she needs to consult with the doc., and when he/she can guide treatment under his/her own discretion. There is no reason a paramedic should have to call for orders to do anything within their scope, although there will be times when a good paramedic will call for orders to consult OLMC.
 
in New Jersey, every ALS patient requires a call to the doctor prior to walking through the ER doors. suffice it to say, I am no longer in New Jersey
 
You must log in or register to reply here.
Back
Top