tag:blogger.com,1999:blog-4505990433916682663.post6535378331620417553..comments2024-03-13T02:04:31.476-04:00Comments on Paramedicine 101: Prehospital use of analgesia for suspected extremity fracturesAdam Thompson, EMT-Phttp://www.blogger.com/profile/18107359165856983910noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4505990433916682663.post-20486934662556297612010-05-19T01:05:32.293-04:002010-05-19T01:05:32.293-04:00Anonymous,
There is no mystery here. You have a f...Anonymous,<br /><br /><i>There is no mystery here. You have a fire dept that has to make a choice between sending the patient in a private ambulance, or the medic rides in with the patient.</i><br /> <br /> <br />I have never agreed with the idea of assigning medics to non-medical equipment, but that is a whole different discussion. <br /> <br /> <br /><i>If he chooses to give morphine and ride in, his engine is now out of service,</i><br /> <br /> <br />Essentially, if the paramedic works as a paramedic, the whole engine is out of service. Nobody got fired for this idea? <br /><br />You can't put out a fire unless you have a paramedic on board?<br /> <br /> <br /><i>he has to fill out all the paperwork to get his morphine restocked, and it wouldn't surprise me if that could take an hour or more.</i><br /> <br /> <br />There is no good reason for these restrictions on controlled substances. These restrictions do <b>not</b> come from the DEA (Drug Enforcement Administration).<br /><br />Regardless of single role EMS or cross trained, it is wrong to create these obstacles to providing appropriate care for the patient.<br /> <br /> <br /><i>Or, he could send the patient in, and be back at the station in 15 minutes in time to watch the latest episode of House.</i><br /> <br /> <br />I haven't seen <i>House</i> in a while. Has he gotten his happy on? I miss hearing my coworkers make comments that <i>there actually is somebody more sarcastic than me</i>. Even if it is a fictional <i>somebody</i>. ;-)<br /> <br /> <br /><i>It's a no-brainer. So the patient is going to be in pain...we'll, it builds character, right? No pain, no gain!</i><br /> <br /> <br /><b>I offer character adjustment services to those who claim that <i>pain builds character</i>.</b><br /><br />I will be covering research demonstrating that this is just a BS excuse. This excuse is used by the lazy and by some misguided religious fanatics, who would fit right in with Osama bin Laden.<br /> <br /> <br /><i>Our service at least has the excuse that we have no standing orders, and if we DO manage to get an order for pain medications, it will be 2mg of Morphine. NOT titrated to effect. Just 2mg.</i> <br /> <br /> <br />Does that mean that you cannot get orders to repeat as necessary? I believe that New York State had laws to that effect. I do not know if the laws have been changed. <br /><br />That is one of the problems when you have non-medical people making medical decisions.<br /> <br /> <br /><i>THEN we get to go through a mind-boggling circus of getting signatures, reports, scripts, and running around the hospital to get restock.</i><br /> <br /> <br />There is no good reason for this. Dr. Kieth Wesley, State Medical Director for Minnesota, discusses this on the EMS Garage podcast - <a href="http://emsgarage.com/archives/546" rel="nofollow">Pain Management: EMS Garage Episode 85</a><br /> <br /> <br /><i>In a lot of places in the US, EMS is still in the middle ages.</i><br /> <br /> <br />I completely agree.<br /><br />I am trying to do my little bit to pull EMS out of the middle ages.Rogue Medichttps://www.blogger.com/profile/07598646309630074992noreply@blogger.comtag:blogger.com,1999:blog-4505990433916682663.post-63833949193937016022010-05-19T00:25:34.882-04:002010-05-19T00:25:34.882-04:00There is no mystery here. You have a fire dept th...There is no mystery here. You have a fire dept that has to make a choice between sending the patient in a private ambulance, or the medic rides in with the patient. If he chooses to give morphine and ride in, his engine is now out of service, he has to fill out all the paperwork to get his morphine restocked, and it wouldn't surprise me if that could take an hour or more. Or, he could send the patient in, and be back at the station in 15 minutes in time to watch the latest episode of House.<br /><br />It's a no-brainer. So the patient is going to be in pain...we'll, it builds character, right? No pain, no gain!<br /><br />Our service at least has the excuse that we have no standing orders, and if we DO manage to get an order for pain medications, it will be 2mg of Morphine. NOT titrated to effect. Just 2mg.<br /><br />THEN we get to go through a mind-boggling circus of getting signatures, reports, scripts, and running around the hospital to get restock.<br /><br />In a lot of places in the US, EMS is still in the middle ages.Anonymousnoreply@blogger.com