Cardiac Transfers - Pump to ?

[mrmeaner]

Does anyone carry pumps small enough that you routinely bring them into a house? For example for that post-arrest dopamine drip you get going in the house?

Yes and no. The pump is small enough that it is easily brought into a home or on an intercept. One problem is that the tubing is different than the hospital tubing. Also, it takes about 5 minutes to clear the air so the pump will work properly. Because of these problems, they are not typically utilized on a short transport.

[CBEMT]

1. The hospitals are afraid of letting you use their pumps and not getting them back form receiving facility. or....

2. Your service does not want to fork out the cash for their own pumps.

What about Dial a Flow? Are you using them?

1. I've had more than one hospital give me their pump on faith that I'm bringing it back (short transport times help). Some will send a nurse for no other reason than to make sure they get the pump back (direct quote).

Dial a Flows were required equipment until our last protocol update. At that point they were banned due to research showing serious inaccuracies. Now the ONLY option for a drip, interfacility, 911, or anything in between, is a pump.

2. And the way the protocols are written, if your service is too cheap to shell out for any, there is NO treatment for stable VT available to you. And if it's unstable VT with a pulse, you're still screwed- sure you might convert, but you won't hold the rhythm!

[Dustdevil]

I'm not sure I really understand what is happening here. Whose idea is it to no longer send RNs on the transfers? I don't understand if this is a TEMS initiative to take on all this responsibility, or if the hospitals are just declining to send people out on the road anymore.

Either way, I would agree with you. This is certainly not an optimal way to do business. I've never heard of such a thing.

[Freaknuggetz_chick]

simple: tell your boss to get pumps. otherwise, pt care is being jeapordized. starting and stopping ntg/dope drips?? c'mon! pumps arent difficult at all.

except when they close and clamp your ntg line....i have an older pump, hates ntg lines.

[Dustdevil]

Yeah, this is not a good plan. By stopping and starting the drips, you have no way to accurately account for was administered during that transport period. And patients on drips are generally unstable to begin with. Turning things on and off and giving unregulated dosages in between is just asking for trouble.

[Ridryder 911]

I do not endorse RN's on transfers unless they are cross trained or specialty trained. Most do not understand that their license/insurance usually stops outside the door, unless the EMS is owned by the transferring hospital-no matter how many physicians orders it.

Our pumps are small enough to carry in the house. They are three chambers, and as well have a function to read out the exact amount administered while enroute. So actually I can give you an exact amount administered during my trip. They also have a "cheat" program for dosages that are programmed in it.

True one has to change tubing, but I can discard the bag if I like and use a syringe if I want to. This is nice that I do not have to "hang" anything and can tape the syringe to the pump itself. No need to "hang a bag" if the infusion is < 60ml/hr. Again, if need be and a bottle has to be used, it can.

What I have found is most medics are not familiar with their equipment. I can change tubing in usually less than a minute and do not have very many troubles. I do see many that do get air in the chamber, have difficulty clearing lines, etc.. again; most from not using and being very familiar with the device.

R/r 911

[sledogg1]

Here in Nova Scotia, we don't have pumps on board but if it goes out on a pump it stays on a pump. its goes to the ALS Crew, PCP'S can manage a NACL on a pump but the rest to ACP'S. We do alot of antibotics, panto etc from rural hospitals,

[mrmeaner]

I do not endorse RN's on transfers unless they are cross trained or specialty trained. Most do not understand that their license/insurance usually stops outside the door, unless the EMS is owned by the transferring hospital-no matter how many physicians orders it.

Our pumps are small enough to carry in the house. They are three chambers, and as well have a function to read out the exact amount administered while enroute. So actually I can give you an exact amount administered during my trip. They also have a "cheat" program for dosages that are programmed in it.

True one has to change tubing, but I can discard the bag if I like and use a syringe if I want to. This is nice that I do not have to "hang" anything and can tape the syringe to the pump itself. No need to "hang a bag" if the infusion is < 60ml/hr. Again, if need be and a bottle has to be used, it can.

What I have found is most medics are not familiar with their equipment. I can change tubing in usually less than a minute and do not have very many troubles. I do see many that do get air in the chamber, have difficulty clearing lines, etc.. again; most from not using and being very familiar with the device.

R/r 911

Alaris pumps?