Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-05T23:23:17.839Z Has data issue: false hasContentIssue false

Assessment of the EMT-P Medications Used by Baltimore County Fire Department EMS Supervisors/EMT-Ps

Published online by Cambridge University Press:  28 June 2012

Harold C. Cohen*
Affiliation:
Lieutenant, Baltimore County Fire Department
*
Baltimore County Fire Department, 4814 Grand Bend Drive, Catonsville, MD 21228 USA

Abstract

Many authorities in EMS have cited the lack of data concerning the efficacy of medications administered by prehospital providers. This paper reports the results of a prospective assessment of the efficacy and safety of certain medications used by emergency medical technician-paramedics (EMT-Ps) in a three-tiered response system. Data were collected for six months using forms that were completed by the EMT-P at the conclusion of an incident. Medication efficacy was measured for: bretylium tosylate, 14 patients/3 conversions to a sustaining rhythm (21 %); diazepam, 20 patients/17 stopped seizing or converted to focal motor seizure (85 %); dopamine hydrochloride, 14 patients/9 experiencing increase of blood pressure (64%); furosemide, 49 patients/28 instances of decreased respiratory distress (57%); and terbutaline sulfate, 46 patients/34 instances of decreased respiratory distress (74%). Serious side effects were rare and well managed by the EMT-Ps. These data indicate that these medications are effective and safe when used in the prehospital environment. Analysis of more data from different delivery profiles is necessary prior to drawing appropriate scientific conclusions. Data collected should include patient follow-up through hospital discharge.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. MIEMSS: Maryland medical protocols for emergency medical technician-paramedics and cardiac rescue technicians. Unpublished 1989; DD–121.Google Scholar
2. Ramzy, A: Discussion concerning preliminary field data for Maryland. Unpublished. Phone conversation 19 December 1988.Google Scholar
3. Stang, JM, Washington, SE, Barnes, SA et al: Treatment of prehospital refractory ventricular fibrillation with bretylium tosylate. Ann Emerg Med 1984; 13:234236.CrossRefGoogle ScholarPubMed
4. Mayer, NM: Management of ventricular dysrhythmias in the prehospital and emergency department setting. Am J Cardio 1984; 54:34a36a.Google Scholar
5. Euler, DE: Deleterious effects of bretylium on hemodynamic recovery from ventricular fibrillation. Am Heart J 1986; 112:25.Google Scholar
6. American Heart Association: Textbook of Advanced Cardiac Life Support. Dallas: American Heart Association, 1987; p. 105.Google Scholar
7. Haynes, RE, China, TL, Copresney Cobb, LA: Comparison of bretylium tosylate and lidocaine in management of out of hospital ventricular fibrillation. Am J Cardio 1981; 48:363366.Google Scholar
8. Holder, DL: Experience with bretylium tosylate by a hospital cardiac arrest team. Circulation 1976; 55:541544.CrossRefGoogle Scholar
9. Fesmire, FM: How much is wide open? (letter) Ann Emerg Med 1988; 17:1000.CrossRefGoogle ScholarPubMed
10. Hoffman, JR, Reynolds, S: Comparison of nitroglycerin, morphine, and furosemide in treatment of presumed prehospital pulmonary edema. Chest 1987; 92:586593.CrossRefGoogle ScholarPubMed
11. Caroline, NL: Emergency Care in the Streets (3rd ed). Boston: Little Brown & Company. 1987.Google Scholar
12. Gazzaniga, AB: Emergency care principles and practices for the EMT-P (2ded). Reston, Virginia: Reston Publishing Company 1982.Google Scholar
13. Stapczynski, JS: Acute cardiac emergencies: acute ischemia, infarction, and heart failure. Emerg Care Quart 1986; 2:5061.Google Scholar
14. ACEP: Prehospital life support skills, medications, and equipment. Ann Emerg Med 1988; 17:11091111.CrossRefGoogle Scholar
15. Gannon, R, Platt, D: Sympathomimetic agents in shock. Emerg Med Quart 1987; 3:1018.Google Scholar
16. Smith, PR, Huerich, AE, Leffler, CT, Henis, MMJ, Lyons, HA: A comparative study of subcutaneously administered terbutaline and epinephrine in the treatment of acute bronchial asthma. Chest 1977; 71:129134.Google Scholar
17. Spiteri, MA, Millar, AB, Pavia, D, Clarke, SW: Subcutaneous adrenaline versus terbutaline in the treatment of acute severe asthma. Thorax 1987; 43:1923.CrossRefGoogle Scholar