Pain relief and EMS

[tniuqs]

In Saskatchewan (another crazy Canadian province) At the PCP (BLS) level we got nothing, The ICP/EMT-A (ILS) have entonox and the ACP has morphine

The EMT/ PCP level in Alberta does have Entonox (the vast majority of sevices) in passing.

The question that must be raised and with the multiple "handles" are used nationally, and PCP this is really not standardized across the many provinces as of yet. I have very serious reservations in allowing IV MS for the PCP level, well with one previso... unless the patient is on a self admin pump.

It was mentioned that the BC PCP maybe giving this on LDTs .... yeah know thats scarry to me.

Question raised is what level is educated "enough" to provide Narcotic Pain relief ? I have serious concerns that just any PCP/EMT could give any IV drugs, just not the background in the vast majority of Canadian programs that I have reviewed, (there is a stong reason to push for all to become ACP) as without background and the other essential tools in place to protect airway and effectively deal with complications ie anaphlaxis and reversal .... these are very serious considerations to my way of thinking, it is Paramedical history if one screws up ALL will be restricted ... sad but true.

Must agree With WelshMedic .... we are not doing as good a servive to our patients as we could be, btw I have never heard of paracetamol IV ? I believe thats what we call Acetaminophen here.

That therefore means that Doris has now gone almost two hours without any decent form of analgesia since her fall, but well, she doesn't like to complain because the nurses are so sweet, but oh so busy. Those busy nurses then leave Doris another 45 mins before they get around to administering the Morphine because of the back log of work.

One will find this situation more the norm than exception, I have made it my personal policy to "top up" for breakthrough pain relief in the last block before the ER ... especially when I know it is busy. Another good trick is using what would be the normally the waste from IV ... say 3 to 5 IV MS as an example (for movement and transport and to effect) the rest IM ... no point in squirting 38 cents of MS down the drain, maybe it's the Scot in me I guess ? <G>

Waste not Want not.

cheers

[rock_shoes]

The question that must be raised and with the multiple "handles" are used nationally, and PCP this is really not standardized across the many provinces as of yet. I have very serious reservations in allowing IV MS for the PCP level, well with one previso... unless the patient is on a self admin pump.

It was mentioned that the BC PCP maybe giving this on LDTs .... yeah know thats scarry to me.

Question raised is what level is educated "enough" to provide Narcotic Pain relief ? I have serious concerns that just any PCP/EMT could give any IV drugs, just not the background in the vast majority of Canadian programs that I have reviewed, (there is a stong reason to push for all to become ACP) (Agreed 100%) as without background and the other essential tools in place to protect airway and effectively deal with complications ie anaphlaxis and reversal .... these are very serious considerations to my way of thinking, it is Paramedical history if one screws up ALL will be restricted ... sad but true.

I agree with you that more education is required prior to permitting the use of narcotics at the PCP level. To my way of thinking it would have to be a license endorsement that can only be obtained through completion of the requisite education modules. Just as another note. BC PCPs (those of us with IV's anyway) do carry Narcan and can administer it SC, IM, and IV. We also carry epi and benadryl although I think it would be prudent to add IV benadryl not just the current 12.5-50mg PO. Of course the use of narcotics also brings about the need for a medication like gravol. Ah hell lets all just go ACP and make life easier :wink: . None of this is going to make any difference to my practise. I'll be an ACP by the time any of this comes to pass.

[tniuqs]

Ah hell lets all just go ACP and make life easier

On the same page !

but what the heck with paracetomol IV ?

[Quakefire]

PCP seems to be the worst level for cross country equality. In saskatchewan i'm trained to the bare minimum for the NOCP, no IV access let alone pain meds, where as some provinces allow their PCP's IV access, pain meds, and other fun skills. Kinda why I want to start training for ACP asap

[WelshMedic]

Paracetamol IV is used to top-up the effects of opiates resulting in lower dosages being necessary.

WM

[rock_shoes]

Paracetamol IV is used to top-up the effects of opiates resulting in lower dosages being necessary.

WM

It's also used to control fever yes? If I remember correctly Paracetamol is what we in North America call Acetaminophen. Acetaminophen is often a great choice because it has an extremely low incidence of allergic reaction and a low incidence of drug interaction.

[akroeze]

I don't believe Paracetamol (Acetaminophen) is available in North America in intravenous form.

[Quakefire]

I don't believe Paracetamol (Acetaminophen) is available in North America in intravenous form.

Last time I saw Acetaminophen was in jam, strawberry to be precise

[WelshMedic]

That's a shame, it really does work!

WM

[WelshMedic]

Last time I saw Acetaminophen was in jam, strawberry to be precise

No, that was Aspartamine.