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So heres another question. In my PA tech class, we took an extra module on Epi-Pens. This extra module lets me carry an Epi-Pen with me when I ride here, and give it to a patient showing symptoms of anaphalaxsys (sp), even if they do not have their own or have a diagnosed allergy. Once I finish my test down here and apply for NY reciprocity, that module will not carry over, correct? Meaning, I can not give an Epi-Pen (if my medical director prescribed one for me to carry), just assist a pt with his or her own? Thanks in advance for the answers.
As per PA State BLS guidelines you do not have permission to carry your own Epi-Pen, you have permission to use the Epi-Pen on your ambulance if your service is approved to have it, and your medical director has approved BLS to use it. You may only administer the Epi-Pen on standing orders if the pt has:
1) "Difficulty breathing and wheezing.
2)"Swollen tounge and lips or difficulty swallowing"
3)"Hypotension"
for any other reaction or symptoms you must call medical command for orders for an Epi-Pen...you may also administer the pt's Epi-Pen however the standards are the same as above...and no that does not carry over to New York when you get reciprocity.
Each county has their own guidelines within New York State EMS protocols---when you receive you reciprosity here and, for sake of argument in Nassau county, each department has their own protocols. My dept does not carry the Epi -pen for BLS providers. Don't ask....Everything will be explained to you as far as protocols when you do get here. Most depts have a training officer or someone may be nice enough to help you out.
NYS BLS Protocal states that you may "Assist in the administration of The Patients epi-pen" however if your agency (at least in Nassau) has whats called a collaborative agreement your agency carries an epi-pen that you can use when a patient presents with anaphalaxsys
too expensive, expires very quickly, rarely is needed.
Who are you, where did you come from and why are you weighing in on multiple threads with stupid comments? I bet if you or a family member were going into anaphylactic shock you wouldn't argue about the expense...
Hospitals are minutes away in new york. If you actually knew your facts instead of throwing around your opinions you'd know Anaphylaxis causes less then 1,000 deaths per year in the country and less then 17% of the population are affected by it when exposed to i.e allergans, pcn, insect bites and of alllll those people maybe 1% die from a reaction. Majority of the people are diagnosed with it and carry their own auto injectors.
Again, if you knew anyyything about it you'd know anaphylactic shock leads to death in mere minutes so you'd be humping chest instead of worrying about your dept. having an epi-pen and also an epi-pen only relieves a limited number of symptoms for a brief period of time. ALS also administers it through an iv, so why waste money on something bls will never use..?
Last edited by kye994 : 04-29-2008 at 07:16 PM.
Reason: don't be a dick
so, what you are saying (this time with supposed facts and figures) is that it is completely pointless for us to carry and train with a potentially life saving device and medication because most people are going to be dead anyway? Furthermore, New York State and REMSCO had no thoughts of this when they approved it allowing EMS agencies to spend hundreds of dollars to stock ambulances and even more to train personnel. Is this some kind of drug company conspiracy? Maybe you like to 10-83 your patients but I think everyone is worth a shot and if .5% of the time we can save somebody isn't that enough? By your logic we should hardly be carrying defibrillators...can you spout some facts about prehospital cardiac arrest survival with no CPR and a 10 minute response time? Finally, not everybody is 10 minutes from the nearest hospital, NYC maybe but you will have ALS there anyway, Long Island, most places you can get to an ED in a reasonable amount of time but we also have our rural areas where you might only get BLS at times. An Epi-Pen will give you about 10-12 minutes to work with so even if they have taken theirs (early enough to prevent a fatality) they may need another by the time you get there to make that quick 10 minute hospital ride. I know it feels cool to live on the edge and challenge the status quo...but a lot of thought and experience has contributed to the formation of the protocols that we follow and your 8 word unqualified answer just makes you look like an idiot...
It's not just in NYC, it's Long Island as well. How many times a year in all of LI are we callled to an anaphylactic? Rather spend the load of money that would've been spent on epi-pens on new training epuipment or better epuipment then we already have.
And the current protocol is we are allowed to "assist" with the administration of the patients auto injecter. Same as we are allowed to assist with the patients nitroglycerin.
Actually providing our own would cause problems because a tech might misdiagnose an anaphylactic with something else and shoot adrenaline into some poor dude.
Rather spend the load of money that would've been spent on epi-pens on new training epuipment or better epuipment then we already have.
Exactly why inexperienced people aren't allowed to make decisions like this, instead we have REMSCO and the State DOH to guide us, good thing ur not in charge....if you want to argue with the decisions that they have made, go ahead, argue
The DOH and REMSCO govern our operations, whether you like it or not you abide by the rules that they implement based on careful study and consideration and the collaboration of medical directors. As an EMT you do not have the medical knowledge necessary to tell them or us that you are correct in this matter. You don't like Epi-Pens, that’s wonderful, but you still have to use them in conjunction with the established protocols and as the patient advocate you are SUPPOSED to be it is your responsibility to do everything in your power to give every patient the opportunity to be treated in the most effective manner available. In EMS we deal with what-if situations, and we need to be as prepared as possible for every possible situation that we encounter. Not having a spare Epi-Pen is not being prepared and is not in the best interests of your patient. I would like to have some experienced CC's and Medics weigh in on this.
I'm not arguing with the rules, when did I ever say that. I said I don't feel it's worth the waste of money we'll end up spending on carrying our OWN auto injecters. I'm not breaking any rules. Once again, were allowed to assist with the patients auto injector, nothings more. Sooo I'm agreeing with the current protocol. Like i said before, if the person already has one and is exhibiting signs and symptoms of anaphylaxis it's commen sense to stick em with it. Carrying our own would cause problems... hence why we don't have our own.
Take this scenario, your BLS Crew responds to a patient exhibiting signs and symptoms of anaphylaxis, they have thier own epi-pen auto-injector however thier last reaction was quite a few years ago and thier epi-pen has expired....S.O.L. or does your department do the pro-active thing and have a cooperative agreement and train your BLS providers to a level where they can administer your dept's epi-pens which yes they may have paid for out of company funds and may have not used ever before but to that tax payer who's life was saved by a dept. being PRO-ACTIVE and not reactive, I am sure will leave a lasting effect! Having access to a tool and b/c we may only use it once in a while does not justify getting rid of it or never getting it. Just think, how many times does your dept. put the jaws to work??? In some of the less busy dept's maybe once a year....does that mean we should sell them off?? make more room on the rig for something else?? No it means we have things standing by...in case we need them.
Point well taken.. but we have a lot more tool jobs a year then anaphylactics. We have a lot more car accidents a year which the possibility of the jaws being used is probable. NYS protocol states we can only "assist" a patient with the epi. Nothing in there about administering our own. Heres a scenario to counteract. Your dept. somehow carries epi-pens, you get a call for an anaphylactic. Only tech onscene is fairly new, sees a person exhibiting signs and symptoms similiar to anaphylaxis. Witness states patient was outside and suddenly fainted. Sticks him with the epi.... but the patient wasnt sufferent from anaphylactic shock. Now he's screwed cause he stuck the guy with a very serious drug when he didnt need it.
If you were diagnosed with it and had your own auto injecter, would you fail to renew it if it expires? I know I damn sure would'nt. Why risk my life like that.?
Yeah its expensive and expires quickly... all that stuff. But sorry to say but its a huge liability because theres inexperienced techs out there that won't be able to diagnose whether its an anaphylactic or something else.
because theres inexperienced techs out there that won't be able to diagnose whether its an anaphylactic or something else.
You are alone on this, the previous poster made the point well. If your tech is inexperienced then they should not be riding alone. Our protocols allow us to assist the patient with a department owned Epi-Pen if they have a standing Rx or on the orders of the medical control MD, we are no just allowed to use theirs...
Every medication we use, in inexperienced or incompetent hands, can be dangerous or fatal, but does that mean we stand by and do nothing because we might screw it up? We learn how to identify those symptoms in EMT class, we are tested on them, there is no reason why anyone who passes EMT-B should not be able to perform this duty, trust me, I teach the damn class... The solution to your concern is training, we do nothing unless we are trained to do it, you make it sound as if the state sent us a box of Epi-Pens with a note that said: "Go wild guys, and tell us how it goes." There are protocols in place, and no one who isn't trained in the use of the device is going to be using it. Should we get rid of albuterol? How about Oxygen, could kill a COPD patient if we leave em' on it too long...
To any new techs who might be reading this: We have protocols and training in place for a reason, sure some of the procedures we are trained in can cause harm if they are performed improperly, but that is why we go to school, attend CME's and In-Service trainings. You guys are patient advocates, you as EMTs have the responsibility to keep up on your knowledge and to speak out for programs, such as the Epi-Pen program, that will due immeasurable benefit to even a small number of patients. We are there for the patients, leave money to the politicians and dept. presidents, it is not your responsibility to carry out a cost-benefit analysis.
Epi-Pens
