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#80269 - 12/26/06 02:56 PM Re: what meds to give to a shock trauma person?
paramedicpete Offline
Pooh-Bah

Registered: 04/09/02
Posts: 1920
Loc: Frederick, Maryland
There are a variety of medical supply companies that sell I.V. solutions on the Internet and may sell to the general public in some cases. Just realize you may have to purchase in case lots. However, you potentially leave yourself open for both civil litigation and criminal charges. Keep in mind, just because you can (i.e. military training) perform a medical procedure, does not mean you can do so in the civilian world.

Medical practice of which EMS procedures are included is limited by state and/or local jurisdictional law to those who are either licensed or certified (state level) to carry out such procedures. I would suspect in rare cases such as a State of Emergency or a personal survival situation, that such legal action might be ignored. There are numerious ALS medical procedures that I can perform while on duty with the Medic unit and equipment. However, if I am not on duty, my scope of practice is limited to BLS procedures only. Hence I do not carry I.V. solutions/supplies in my personal vehicle.


Pete

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#80270 - 12/26/06 08:10 PM Re: what meds to give to a shock trauma person?
kd7fqd Offline
Enthusiast

Registered: 08/07/05
Posts: 359
Loc: Saratoga Springs,Utah,USA
Pete I agree with you, my scope of practice is also limited to BLS outside the hospital (however) one of my ER Docs is medical control for our SAR team that I am on and does issue LIMITED drugs to us (max 2mg morphine, also call on IV's Lifeflight must be within 5min before IV starts) I enjoy SAR and wouldn't trade any of it
Mike
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EDC: Samsung Galaxy Note 2,DR PSK, Swiss Army Champ, Leatherman Blast
My Blog emergencybobs.wordpress.com


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#80271 - 12/28/06 02:50 PM Re: what meds to give to a shock trauma person?
physics137 Offline
journeyman

Registered: 10/28/03
Posts: 64
Loc: New York City
I'm an EMT in NY State. Here's what we do for shock (hypoperfusion):

1. Give oxygen, preferably 10-15 L/minute via non-rebreather mask, or by bag-valve if necessary.

2. Keep the patient warm (put a blanket over them)

3. Have them lie down supine (face up) with legs elevated (exceptions being cardiogenic shock when you don't want to elevate the legs, sometimes in cases of pulmonary edema and other respiratory compromise where lying down inhibits breathing, and trauma cases where leg elevation may compromise the spine - in the latter you can elevate the foot end of the rigid backboard.)

4. Provide calm reassurance

5. RAPID transport to the hospital where definitive care can be obtained, regularly monitoring the patient's vitals.

In particular, we DO NOT push meds, we DO NOT give food or liquids, and we (where I am) do not use shock trousers (MAST).

Read our protocols here: http://www.health.state.ny.us/nysdoh/ems/pdf/emtblsprotocols.pdf

Go to Page 92 for the Hypoperfusion protocol.

Paramedics have a broader scope of training and may have a wider set of tools available, but I'm not a paramedic, and unless you are you shouldn't be providing paramedic care.

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#80272 - 12/28/06 02:55 PM Re: what meds to give to a shock trauma person?
physics137 Offline
journeyman

Registered: 10/28/03
Posts: 64
Loc: New York City
Exactly Pete.

There are two possible outcomes when you give treatment to a patient:

(1) It improves the situation

(2) It makes the situation worse.

If (1), then great. If (2) you're in trouble.

If you're going to do something, it pays to be right.

Therefore it makes sense to have the training that you're more likely to be right.

But on the off chance you're wrong, then you better be prepared to explain why you believed your course of action was reasonable given what you knew at the time, AND was within your scope of training, and hope someone else agrees with you that you were reasonable in your action (this is the essense of the good sam laws).

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