New Lopressor protocol

[FL_Medic]

Our service has just updated our guidelines to include lopressor in our Acute Coronary Syndrome protocol.

Is anyone else doing this?

[EmergencyMedicalTigger]

I've never heard of Lopressor being used in a prehospital setting. I've seen it used in the ER but don't recall the exact amount of time it took for the meds to take effect. Is it really worth it to carry this drug on the ambulance considering the possible side effects and the extensive list of common drugs it can interact? What are your thoughts are carrying/using Lopressor?

[Ridryder 911]

Out new medical director is proposing us to carry it. The standard dosage IV is 5mg q 5 minutes up to 15 mg .. of course one has to be sure not bottom out the pressor or bradycardia...

R/r 911

[FL_Medic]

I've never heard of Lopressor being used in a prehospital setting. I've seen it used in the ER but don't recall the exact amount of time it took for the meds to take effect. Is it really worth it to carry this drug on the ambulance considering the possible side effects and the extensive list of common drugs it can interact? What are your thoughts are carrying/using Lopressor?

Our medical direcor is a pretty smart guy and has alot of confidence in our medics. I am researching it now, but honestly if he thinks we should carry it he is probably right. Our agency sets standards throughout the country and our protocols are constantly being reviewed by our peers and complimented for being progressive. This could be a mistake, but I think it will probably be another advancement that we will start seeing other agencies mimic. Anything that decreases o2 demand during an MI is a good thing... and decreasing the HR is the best way of decreasing the workload. This is the drug that can do that, we have decreased o2 demand by vasodilation, now we are gonna hit the HR, I am for it.... so far.

[p3medic]

we carry it here, have for several years now, we use it in AMI and rate control for AF.....5mg q 5 min to a max of 15mg....

[AZCEP]

Keep in mind the only drug proven to improve survivability in an AMI is ASA.

Not even fibrinolytics or PCI can tout that they improve morbitity/mortality numbers.

It's great that your medical control has the leeway to be able to decide what his medics will be allowed to do without answering to some higher bureaucracy, but try to consider that not everyone has the same level of autonomy. Medical directors can want, but until state or regional councils agree, nothing can happen.

[FL_Medic]

Keep in mind the only drug proven to improve survivability in an AMI is ASA.

Not even fibrinolytics or PCI can tout that they improve morbitity/mortality numbers.

It's great that your medical control has the leeway to be able to decide what his medics will be allowed to do without answering to some higher bureaucracy, but try to consider that not everyone has the same level of autonomy. Medical directors can want, but until state or regional councils agree, nothing can happen.

understood

[1EMT-P]

Lopressor- 5mg via IV over 5 minutes. May repeat after 5 minutes to a maximum dose of 15mg.

[FL_Medic]

Lopressor- 5mg via IV over 5 minutes. May repeat after 5 minutes to a maximum dose of 15mg.

what are your thaghts... we have the same dose.

[Code 8 Paramedic]

Lopressor is making its way into our trucks. My service isnt carring it yet, but some of the other medics i know have it on the truck and in their protocols.