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Necroposting, Mike?
i don't know about anyone else but what i learned when i went thru EMT-B class i was taught that O2 is therapeutic to a chest pain pt. i also learned that if a protocol states to put them on high flow O2 then do it unless there are circumstances that don't permit then contact medical control and let them decide. Protocols are guidelines but they are also there to CYA. If you deviate from them then you need to document why and weather med control was contacted. If you have a good QA person they will help you questions as to treatment and protocol and if someone did something that you thought was wrong then they can deal with. Just some food for thought so to speak.
Eh, good bump nonetheless,
The issue of addressing disagreements on scene and even focusing on who really is in charge does hold true. If I was responding to such a call and had the same comments directed at me, I would have words immediately after the call. I have no problem with someone making suggestions and working as a team, but there is a difference when undermining someone's call on scene. It is one thing if you see something which can be detremental to pt care and can seriously harm the pt, but another to think one knows better and does what they want despite what is asked for.
Actually, with the advent of pulse oximetry and the move to evidence-based medicine, high flow 02 isn't indicated nearly as much as was thought even three years ago.
The reason - some medical conditions release free radicals. Free radicals plus oxygen equals ??? (You're a hazmat guy, so that's a teaser for you. Think "hazmat reaction inside the body".)
:-)
Happy Thanksgiving.
Geez Mike, where did you find this post? I had forgotten all about it until I saw an email notification that you had "bumped" it.
Well, after 3 1/2 years of hindsight, I can make the following remarks about the incident:
The ALS agency does not exist anymore, solely for financial reasons
The EMS community at the time was having issues with decisions made by a few members of the now defunct agency
NYS BLS protocol still mandates high flow oxygen for potential cardiac problems
Regional ALS protocols indicate titration of oxygen to maintain > 95% O2 sat
NYS DOH rules state the highest trained provider on scene is in charge of patient care
So, I should have done what the ALS provider requested.
Happy Thanksgiving, all!
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