Why do we UNDERTREAT our patients ?

[Yummymedic05]

I don't carry AC, it's not in any of my standing orders, and I have never once seen it given in the hospital I work for. I can't stand puke, but working/volunteering in the medical field since I was 13, and seeing it be given a whopping 3 times that I can think of...I've never seen anyone puke from it.

[Cookie]

We carry it as part of our protocols, but don't recall it being used ever.

Last clinicals I had we had two back to back attempted suicides, and the hospital used it. Both patients puked it up, and they were readied for another dose or two.

[ncmedic309]

I've got the best excuse of all for not using it, we don't carry it! Even if it were on our trucks, the vast majority of our transports are less than 20 minutes in duration and that doesn't allow you a lot of time to mix up a slurry in between getting the rest of your assessment and treatment out of the way. I could see it being used in more rural settings where you have extended transport times, but in most urban EMS systems, I don't see the need for it...

[medic429]

Well, I thought I said my piece earlier, until I read this crap. Wasn't going to respond, but something about the presumptuous nature of this individual inclines me to step up on my soapbox for a moment...................

First off, I think there is more to this story than you "started working in the ER and now see the light of how little we care for our patients". Did something bad happen to you or someone you are close to?

Next, you are wrong in your estimates. Since January 2006, I have run the following calls:

OD's - 12

Cardioversions - 4 in flight

Pedi Arrests - Typically don't fly arrests, but have worked 4

OB's - 3, we do not fly active labor patients

Burns - 17

Seems your x10 estimate is slightly incorrect, go back and learn some basic math.

You do not know my protocols for OD patients and I doubt seriously that you have anything close to available interventions pre-hospital.

I don't think anyone cares about convincing you about anything as you seem to already be the all mighty knowledgeable about everything OD, except having the ability to read current literature and speak to people who are actually experts and get there recommendations.

Plus you can spare me the whole "cleaning up a mess" crap. After the condition my helicopter is in after most calls, I would welcome an OD patient....................

Like I said before, there are reasons why EMS agencies do not carry the drug anymore and it has nothing to do with failing our patients. If all of these medical directors agree, who are you to change their minds. Let it go, or produce a PROFESSIONAL method of research and statistics to show validation of why our medical directors should change their mind. Coming in here saying that we are not "advocates for our patients" and that we "fail our patients", isn't going to get you far in this family! Go take some Xanax................

just want to say "thank you" flight......could not have said it any better!

[Connie31079]

We used to carry it, but over a year ago, it was pulled from all our trucks.

The reason that was given to me was that it would be too hard for us to intubate any patient who happened to become unresponsive after administration of activated charcoal.

I can see their point. I can imagine how difficult it would be to visualize the cords after my patient had taken AC.

I'd never given it to any of my patients when it was on our trucks.

[Scaramedic]

I am sorry, I just can not agree with the statement that it is no more underused than any other drug. I tell you what, I will make you a deal. I will pay you $5.00 for every AC administration that occured at your service in 2005, if you will pay me $1.00 for every case where it was indicated, needed, but not done. . DEAL OR NO DEAL ?

](*,)

:roll:

Peace,

Marty

:joker:

[Ace844]

"GAmedic1506,"

Seems to me that this technician is more a fan of Betty Crocker Medicine, and when he gets the occasion tries to float his flawed statements and lack of Pharm dynamics, Pharm kinetics, bioavailibility, Phys, and patho-phys, on the back of the Pillsbury Dough boy for the 'cute' presentation factor. Fact of the matter is your statements and understandings are skewed. Kindly spend some time reading the TOx literature and Pharm literature and get soem education before you talk trash... :roll: :shock:

OUT HERE,

ACE844

[GAmedic1506]

OK, this doesnt apply to flightmedics or services that do not carry AC. Let's play "courtroom":

Plaintiff Attorney: Mr. medic, did you respond to a 14 year old female who had overdosed on "abc" pills approximately 20 minutes prior to you arrival on the date of 07/14/05 ?

Mr. Medic: Yes

Plaintiff Attorney: You arrived on the scene at 14:31, and recorded phone records indicate that you called poison control at 14:35.You were told that Activated Charcoal was the treatment of choice, is that true.

Mr. Medic: Yes

Plaintiff Attorney: You then transported this patient to the nearest emergency room, is that correct ?

Mr. Medic : Yes

Plaintiff Attorney: Records show that you left the scene at 14:54, why was there a delay.

Mr. Medic: We had to assess her, load her on the stretcher and move her down some steps.

Plaintiff Attorney: So when you left the scene, the pills had been in her system for approximately 30-40 minutes.

Mr. Medic: I do not know for sure, thats what the patient told us, I wasnt there when she took the pills

Plaintiff Attorney: Did you start an IV

Mr. Medic : yes, while enroute to the hospital

Plaintiff Attorney: Why

Mr. Medic: In case we needed to administer some emergency medications.

Plaintiff Attorney; So you thought there was a chance that her condition would deteriorate

Mr. Medic: Well, she had overdosed on "abc".

Plaintiff Attorney: So, as her body absorbed these meds, there was a chance for her life to be endangered.

Mr. Medic : Uuuuhhhhhhhhh, yes

Plaintiff Attorney: Mr. Medic do you carry Activated Charcoal on your ambulance

Mr. Medic: yes

Plaintiff Attorney: Is Activated Charcoal difficult to administer, I mean does it require special equipment, or special training, does it take hours to mix

Mr. Medic: Well the prefered method is to administer it via an NG tube, but it can be drank from a cup.

Plaintiff Attorney: So then I guess someone who was totally untrained could adminster it, if you only have to pour it in a cup. As a matter of fact, I believe this is sold over the counter at drug stores to the public. Is that right

Mr. Medic: Yes

Plaintiff Attorney: So if it is sold to the public, over the counter, it must be a pretty safe drug, am i missing something? Could this medicine have killed her if you gave it to her

Mr. Medic: Well if she lost consciousness, it could cause airway problems.

Plaintiff Attorney: Why would she lose consciousness

Mr. Medic: Well as the body absorbed the medicines ........................ ddoooppppeeee

Plaintiff Attorney: We now know that our plaintiff has kidney and liver damage because these medicines were allowed to be absorbed in her body. You could have stopped this absorbtion within 5-10 minutes after you arrived on scene, and you knew it was needed, because poison control told you it was the treatment of choice, why didnt you administer it ?

Mr. medic: Uuuuuuuhhhhhhhhhhhhhhhh

Plaintiff Attorney: You knew the patient needed treatment, You knew that her condition was likely to worsen, You had Activated Charcoal in the drug-box, but YOU chose not to give the medicine that would save her life. Her life-expectancy has been tremendously reduced, she is now on dialysis for the rest of her life. I ask you again Mr Medic, why did you choose not to save this patient's life:

Mr. Medic: Uuuhhhhhhhhhh, the hospital was just 20 minutes away.

Uuuhhhhhhhhhh, we dont have a protocol for that

Uuuhhhhhhhhhh, no one in my state gives it

Uuuhhhhhhhhhh, if she vomited, I would have trouble intubating her

Better yet, you'all write the excuse that gets you out of writing a big check.

[AZCEP]

Great analogy :roll:

OTC means safe? On what planet exactly?

No protocol? Sounds like a medical direction issue, not the street provider.

If NO ONE in the state uses it, how does it magically appear in this medic's hands.

I am beginning to think that you have had first hand experience with this issue, and wish to ASSUME that everyone makes the same mistakes. Keep painting with that broad of a brush, and you will end up covering more up than you will fix.

[Ace844]

Why does it feel-seem like we are talking to ourselves in regards to this poster...???? Perhaps because we are. This individual needs glasses, and a clue..

ACE844