WMN Editors

Medications That an EMT Can Administer or Help Administer

/in , , , , , , , , , /by

 

_WMN-cover-27.6

ISSN-1059-6518

The Backpack or Traveling Pharmacy

By Frank Hubbell, DO

A group of long time friends, three couples and various children, were always coming up with new adventures to share. One of the couples loves to sail and suggested that they should all get together and rent a sailboat for a couple of days and go for an ocean voyage. Over the next several months that idea for a great vacation grew, as did their enthusiasm. They eventually were able to rent a sailboat along with its captain in the US Virgin Islands for their Great Adventure. The ship could accommodate all ten of them for a grand week of cruising on the great blue Caribbean sea.

Off they went to the Caribbean and for the first three days all went well. In the evening of the forth day, several of the younger kids began to feel sick with scratchy, burning throats, itchy eyes, runny noses, and upset stomachs. Because they were all in such close quarters the adults decided that the kids were either coming down with colds or allergies. Over the next several hours their conditions worsened and two of the kids began to complain of a sensation of shortness of breath accompanied by wheezing. At the same time several of the adults confessed that they were also beginning to fell sick, with similar symptoms. One of the adults complained of a burning, peppery taste in her mouth. Obviously, they were all getting progressively alarmed.

After sailing all day, the group was now anchored in a nice little hurricane hole on a remote uninhabited island. They would have to wait until morning to head for the nearest port, about four hours away once under sail.

A call was placed to the US Coast Guard who after listening to all the symptoms, thought it might be scombroid poisoning from eating fish that was not properly stored and refrigerated. They explained that it was a form of histamine overdose from eating the fish, in this case mahi mahi, and they needed to treat everyone onboard with antihistamines plus anyone who was wheezing would also need use a rescue inhaler, a bronchodilator such as albuterol.

 

There were no pharmacists, nurses, EMTs, or docs on board. The group needed to figure this out themselves. They decided to gather all the medications that each of them had brought and see what they had that might be of help. What would have helped the most was good old fashioned KNOW HOW. By the way, no internet service was available, just advice from the Coast Guard via their marine radio that the Captain was required to have on board the boat. (And no, the boat was not the USS Minnow on a 3-hour tour.)

 

This article highlights standard information that is taught to EMTs. The medications mentioned are ones they can and will commonly use in providing emergency medical care. Some of these medications are over-the-counter meds while others are prescription meds. The following section covers the basic pharmacological aspects of EMT training.

Read more

WMN Editors

AIRWAY PART I: ANATOMY and PHYSIOLOGY of the RESPIRATORY SYSTEM

/in , , , , , /by

Cover

ISSN-1059-6518

 

The Challenges of Emergency Airway Management:

 By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

First, let’s define the problem:

 

1.     When the need for emergency airway management arises, it is usually a scene that is already difficult, desperate, rapidly deteriorating. A scene that most likely requires critical care skills. One of those rare times where speed is of the essence.

2.     Your patient may be unruly, uncooperative, or even intoxicated.

3.     Your patient will most likely already be hypoxic with poor oxygenation and decreasing respiratory and ventilatory efforts. As a result they will not tolerate even short periods of apnea or hypoxia.

4.     Your patient may have recently eaten or drank, and these stomach contents dramatically increase the risk of vomiting and with the risk of aspiration.

5.     Their airway may already be compromised by blood, vomitus, secretions, or distorted anatomy from trauma.

6.     Your patient may be a cardiac arrest or a near-arrest situation.

 

OXYGEN: Let’s begin this discussion with oxygen.

 

When we talk about the importance of maintaining an open airway, what we are really talking about is the importance of a constant, uninterrupted flow of oxygen to every cell in the body. The cells with the greatest demand, and therefore the most sensitive tissues to oxygen supply, are the nerve cells that make up the brain. These neurological tissues can only survive intact for 4 – 6 minutes without oxygen; after 10 minutes without

O2 , irreversible brain damage occurs and most likely death.

 

The human brain makes up 2% of our total body weight, but it is hypermetabolic:

– it requires 15% of our cardiac output,

– 20% of total body oxygen consumption, and

– 25% of the total body utilization of glucose.

  Read more

WMN Editors

THE USE OF MEDICAL OXYGEN IN EMS

/in , , , , /by

YIGH header

ISSN-1059-6518

Volume 26 Number 4

By Frank Hubbell, DO

Illustrations By T.B.R. Walsh

MEDICAL OXYGEN (O2):

To be used on anyone who is exhibiting signs and symptoms of hypoxia:

 

Shortness of breath

Increase or decrease in respiratory rate

– Adult: respiratory rate less than 10 or greater than 30

– Child (1 year – 12 years old): respiratory rate less than 15 or greater than 30

– Infant (0 – 12 months old): respiratory rate less than 25 or greater than 50

Increase in heart rate.

Change in level of consciousness.

Change in skin color: pallor or cyanosis.

 

 Never, ever withhold oxygen from someone who appears to need it.

The following is needed to provide supplemental oxygen to a patient:

✔  O2 tank

✔  Regulator

✔  Delivery device – O2 mask

 

 Medical Oxygen Storage Tanks:

Come in various sizes.

✔ Are identified by color– either the entire tank is green or the curved part of the tank, “the shoulder,” is green

✔ Have an identifying yellow, diamond shaped label on the tank that is marked U.S.P. and Oxygen

✔ Full tanks contain 2000 PSI of pressure and must be handled properly.

 

Read more