CobraIV
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I need to study the lastest Mass protocols, does anyone have the link,all I am getting is dead links. Thanks
Updated Mass Protocols
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JPINFV
Gadfly
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All of them can be found at mass.gov/dph/oems
Or
http://www.mass.gov/eohhs/docs/dph/emergency-services/treatment-protocols-1001.pdf
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Or
http://www.mass.gov/eohhs/docs/dph/emergency-services/treatment-protocols-1001.pdf
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CobraIV
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thanks guys
Brandon O
Puzzled by facies
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Not much new for Basics, although feel free to throw around some ice packs if you get ROSC and your ALS is still on the other side of the moon...
Brandon O
Puzzled by facies
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Sorry, thanks Dan -- with med control. Very much doubt you'll get a real drop in core temp with our little disposable ice packs, but what the heck. And yeah, the BLS narcan has been extended to a statewide service option (vs. a special project undertaken only by -- I believe -- Boston EMS and Cataldo).
Edit: now that you've got me looking at it again, I notice something that I missed before -- the "Patient is intubated or appropriate rescue airway." Assuming by the latter they mean blind airways like the King, this pretty much knocks out the whole idea of BLS hypothermia. It also says "in setting of STEMI," which we also wouldn't know. These points may not be intended for BLS, but they're listed in the universal indications. This is a sort of unclear protocol.
Edit: now that you've got me looking at it again, I notice something that I missed before -- the "Patient is intubated or appropriate rescue airway." Assuming by the latter they mean blind airways like the King, this pretty much knocks out the whole idea of BLS hypothermia. It also says "in setting of STEMI," which we also wouldn't know. These points may not be intended for BLS, but they're listed in the universal indications. This is a sort of unclear protocol.
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Steam Engine
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Does anyone know offhand any services electing to add BLS Naloxone?
Also, Brandon...I stumbled across your website the other day through a link in one of the threads. Excellent info, nicely done.
Also, Brandon...I stumbled across your website the other day through a link in one of the threads. Excellent info, nicely done.
Brandon O
Puzzled by facies
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Thanks!
No other services I know of, but it's obviously early. I imagine it'd have to be a service area with a lot of overdoses -- maybe Trinity or Patriot? Worcester?
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Worcester is all ALS I believe. Maybe AMR Springfield could consider this. At the end of the day though most private companies are probably going to forgo adding naloxone (or albuterol nebs for that matter) on BLS trucks because of cost, and the fact that ALS or a plethora of hospitals are fairly accessible in urban areas.
So... I'm actually implementing BLS narcan for a small service, happy to provide more info offline... I asked my medical director about the rescue airway mention... She understood it to include OPAs, but I have a call into OEMS for something else this weeks and will ask. I also can't see wide use BLS ROSC cooling, sorry.
Brandon O
Puzzled by facies
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Good stuff Dan. I fired off an email to OEMS as well.
Brandon O
Puzzled by facies
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Per OEMS: "rescue airways" includes OPA/NPAs, and the STEMI item does not apply to BLS.
Meursault
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I was told a year ago that Quincy PD and/or Fallon have IN Narcan on some units for exactly that reason. I doubt it's in the whole hundred-plus fleet, though.
AMR Brockton might benefit, but they might also be all-ALS.
I was always under the impression that hypothermia was only induced in an intubated individual. Additionally, I believe all of the clinical research has been of patients who are intubated. So that seems out of reach of BLS units.
Brandon O
Puzzled by facies
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Maybe just Fallon's Quincy-area trucks...
Brandon O
Puzzled by facies
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With permission, here's the exact response I got from OEMS:
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Quincy PD has had the IN Narcan for a while, or so said my refresher instructor. I don't think Fallon ever did, they are yet to even place glucometers on their trucks as well...
Dedicated Brockton AMR trucks are ALS, I imagine from time to time non-dedicated AMR BLS ends up pulling coverage in the city.
Wouldn't it be nice if all companies put glucometers, pulse ox, and narcan on their dedicated 911 trucks. As I've said before, they are relatively low cost, low risk when used appropriately, and effective, perhaps more so than some of the other tools we carry.
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I imagine you would find all these things on a dedicated 911 BLS truck. The problem is that these units are a dying breed. With the advent of towns contracting for only ALS coverage and allowing BLS units to only respond to 911 calls if no ALS is available, dispatchers are just throwing the closest truck to the call in there. If 90% of the calls that the BLS trucks take are transfers, many companies aren't going to "properly" equip all their units. I guess I feel lucky that all my trucks are equipped the same, though we have no nebs nor narcan.