Epi-Pen protocol for new legislation

[jbrohl]

Has Detroit/East MCA written a protocol for the new epi-pen legislation?

[mike]

If you look on the site you will see the most current protocols they have in effect. I know they have made changes and submitted them to the state so in the next few months they will change (again, they just came out 6 months ago) but as a direct answer to your question I don't really know if it includes the epi-pen legislation

[anthonyt]

I've heard that the epi pen protocols are supposed to be released in the next version of protocols....

[MAGOOMEDIC]

Boy that would be a giant step forward for the system.

If we could get rid of Jenny from the block, we could have a very progressive EMS system.... I'm sure we have all herd her say that our JOB is to bring the patients to her "SO SHE CAN FIX THEM".. We dont need to have people like that in this position........



Again just my .02


-D

[dfdmedic498]

I don't know why we would get a protocol for epi-pens. We already carry plenty of epi already in our box to handle any anaphalactic reaction. I carry my own epi pen for myself and I'm NOT sharing! lmao! :butthead:

[jw]

Even if they were equipped on the trucks I'm sure we'd have to call and get orders for that too....

[mike]

Actually, when was the last time the department gave you the current protocols?

um...never.....

[MAGOOMEDIC]

Well the ALMIGHTY DEMCA could have joined the regonal protocol a few years ago but Jenny did not see it fit to grow the protocols for our area.

I think that whole thing with the good Dr. keeping us down just SUCKS, cuz when she does things to us she does it to everyone like Grose Point ect.

So I cant see a new epi-pen protocol, she will say no need for ALS and no way in hell for BLS and that is just WRONG !!!!!!!!


-D

[dfdmedic498]

The real tragedy here is that there are a few of the e.r. docs that want change for us in a positive light. They have handed out questionaires asking us about topics like calling code 7's on cardiac arrests after working them on the scene, ect... And yet it'll never ever change with the almighty, short "power to be" that is currently holding us back. There are some on the board that would like to see Detroit EMS move forward and be up to date, but it's always the same old song and dance.

There are a few folks on the job that do have full copies of the protocols. Ask around, I am sure that those that do have them, can help you out with getting you a full set. I'll look around for my set and if I find them, I'll be more than happy to make anyone a copy.

[mike]

If you look on this site they are here in full both in text

You can search through the index here:

http://www.dfdems.com/DEMCA/protocols.htm

You can also find the specific topic and go just to it.

You can download the whole thing for yourself here:

http://www.dfdems.com/downloads/downloads.htm

You can also download the whole map book that alot of rigs dont have.

You can also get a map to each PD precinct, as in where it located on mapquest if you click the address..

If anyone has a list for fire and ems stations let me know and I will put it up the same way...

[anthonyt]

Isn't there a section on ceasing recusitative efforts???? I could have sworn I saw one.... I'll try to find it...

[mike]

you can, the chief was the one who says no, go figure....

[MAGOOMEDIC]

Is there some place we can print out a new chief? I think that Doc J and the chief should find another day job cuz they suck at there night one...



-D

[anthonyt]

I have never worked anywhere else that prohibits the practice of following the protocols. Anywhere else they understand the idea that if it is in the protocol... and you do it like the protocol says, and it was an indicated treatment, then all is good liability rests with the medical director. But this is not everywhere else.

[mike]

Section 2.7 of the DEMCA Protocols (http://www.dfdems.com/DEMCA/2-7.htm)

SECTION 2.7.3 - Discontinuance of Advanced Life Support

A. Medical cardiopulmonary arrest patients undergoing attempted resuscitation will not be transported emergently unless return of spontaneous circulation is achieved or emergent transport is ordered by Medical Control. ALS resuscitation will be continued at the scene unless:

1. Advanced procedures (Intubation, IV/IO access, etc.) are unsuccessful - Prompt emergency transport will be initiated.

2. The ALS crew believes that prolonged resuscitation at the scene will be unduly distressing to the patient’s family or bystanders - Transport may begin prior to termination of resuscitation.

3. Resuscitation cannot be safely or efficiently performed on the scene - Transport may begin whenever deemed appropriate by the ALS crew.

B. Medical Control should be contacted as soon as practical during the resuscitation attempt.

C. If the attempted resuscitation has been unsuccessful after at least 25 minutes of ALS treatment, the resuscitation may be terminated with the permission of Medical Control, unless there is persistent Ventricular Fibrillation, in which case prompt emergency transport will be initiated.

D. Once resuscitation is initiated by ALS, it may be terminated only at the discretion of Medical Control.

E. The ALS crew may elect to continue resuscitation for longer than 25 minutes or during transport. The ALS crew will inform Medical Control of the decision to continue resuscitation and initiate transport.

F. Once a resuscitation is terminated, the pre-hospital personnel will provide information to the family which should include Medical Control procedures for termination of resuscitation.

G. Authority for the management of the patient in an emergency is vested in the licensed health care professional at the scene who has the most training specific to the provision of emergency medical care.

SECTION 2.7.4 - Pronouncement of Death Due to Cardiovascular Unresponsiveness

A. Present to the Medical Control Physician (MCP) the results of the physical examination, including vital signs.

B. Present the results of cardiac monitoring, or use of AED (if applicable).

C. Present the following information regarding the patient’s condition:

1. Present problem

2. Past medical history, especially as this relates to any terminal illness which may be present.

3. Applicability of any advanced directives.

4. Presence of Durable Power of Attorney, physician, and/or family members and their agreement in limiting life support.

D. If applicable, present a summary of ACLS procedures and their results (i.e., asystole, pulseless electrical activity, etc.).

E. The Medical Control Physician will then:

1. Pronounce death; or

2. Direct the initiation or continuation of life support; or

3. Order “comfort care only” procedures (e.g. oxygen, suction, medications, transport, etc.); or

4. Request further information to clarify issues.

F. Record the time of pronouncement of death, name of the Medical Control Physician, and Medical Control Hospital.

G. Follow the documentation and notification procedures detailed in the “Declaration of Death on Scene” protocol. (6-10).

[anthonyt]

Well there it is then

Is there a department policy contradicting this??? in writing I mean...

[mike]

Is there a department policy contradicting this??? in writing I mean.

Wouldnt it be nice if there was a book or a site that had all of the memos up so that you could read them. The farce that they have in place now doesnt work in some houses

[MAGOOMEDIC]

Why this way they can charge you for shit that you didnt know..


But it is nice to see that our own leaders would inact rules that would keep us from doing what right...(Family wishes)


I'm sure that someone in the legal Dept. said that that would be good, no liabilty
DONT trust your employees to do the right thing just tell them to transport as many patients as you can...


NICE !!!!

-D

[dfdmedic498]

If that's what the protocol states, then you can't be charged with doing the right thing.
their
Dr. Dunne had a questionaire out this past fall about pronouncements on scene. I think he is trying to make it easier for us to do our job in this aspect. As long as there is someone inside of the home with a level head and there always is. I am sure most familys would agree that their elderly loved one would rather be at peace in the confines of their home.

But like protocol states, cross your T's and dot your I's before you consider calling someone D.O.S.

As a common rule for me, if they aren't rigor, they go.

[bigwoody00]

Get rid of Jenny-on-my-kok...... I have talked to alot of the ER Docs from all over the DMC and most them agree that she needs to go... There are alot of good docs that want us to be more useful out in the field. Can we Vote DR. J out after we vote in a new Union rep???

[dfdmedic498]

I'd LOVE to see Dr. D in place of her. He's a fantastic doc and has the knowledge and right disposition to make EMS move forward into the 21st century.

[bigwoody00]

One could only hope that he will be the next Medical Director...

[bigwoody00]

Eric, you just want to swing from his poney tail...lol

[dfdmedic498]

LOL! Nah, I just like the guy. He's a really nice guy and a great doc. He was the attending when one of my twin sons coded a few years back, so maybe I'm just a weeeeeee little bit biased...lol. But I know he would get the job done. I know he can get the job done, my son is still alive thanks to him and the day crew at Medic 4 that ran here back in 2001!!!

[bigwoody00]

wow... maybe you should offer to fix his roof!!!!!!!!!

[dfdmedic498]

Like he needs a new roof? That's just plain silly dude...lol

[bloodn'guts]

you silly bear you....

[bigwoody00]

lol... just trying to help you be Pope, and get into heaven.

[bloodn'guts]

then sainthood after that...or maybe just a statue...

[bigwoody00]

That sounds delicious......a statue.....

[bigwoody00]

Maybe an arm patch in dedication to Medic498 to be worn on the right shoulder..lol

[bloodn'guts]

or those pope masks of 498

[bigwoody00]

LOL, are you confused with the masks that the KKK wear??

[bloodn'guts]

nooo, the pope had masks or how about 498 pope hats than...

[bigwoody00]

I like that Idea better....

[MAGOOMEDIC]

Yep, sure if we cant get the chief to let us work the casinos how in the HELL are we gonna get him to take on the DMC....


This needs to start at the top... NEW CHIEF, and maybe we may see some changes...