Should dispatchers tell callers how to give allergic reaction medication?

[x635 4,066]

Should dispatchers tell callers how to give allergic reaction medication?

Austin EMS officials push for national standard on giving instructions over the phone.

By Tony Plohetski

AUSTIN AMERICAN-STATESMAN STAFF

Monday, April 13, 2009

On the day she dialed 911 in November, the caller knew from a previous near-fatal experience that her 80-year-old husband was probably having a severe allergic reaction and needed an urgent dose of a potentially life-saving drug.

FULL STORY: http://www.statesman.com/news/content/news...13dispatch.html

[FFFORD 27]

why not? if it has the ability to save a life, what should stop it. i feel it should be prescribed epi to the individual though. forgive me i didn't read all teh article. civilians are not trained under tense situations, but if an effective dispatching strategy enabled them to become calm and collected why not. i mean an epi pen, come on. as long as a person can give it in the leg and not the neck, i think all would be well.

[SRS131EMTFF 471]

Yes 100% X2. As a former sufferer of severe allergic reactions to bee stings I think that it would make sense to train 911 dispatchers on how inform and instruct a civilian samaritan on how to administer a simple auto-injector. It it not very difficult to use an epi-pen, in fact it is almost idiot proof. There are instructions in writing and diagrams on how to administer it. If a 16 year old camp counselor can administer an auto injector without any medical or first aid training as is the case currently, then I am fully confident that a trained dispatcher can instruct a passer by on the finer methods and uses of the medication.

It is very easy to save lives with epi pens, partially due to the ease of use....if someone has an epi pen to use, then there is no reason they should not use it.

[IzzyEng4 427]

With the national push for pre-ambulance arrival instructions dispatchers are already doing it. When I was still dispatching here in CT we gave pre-arrival instrutions for all incidents. Remember an emergency call begins when the caller dials 911 and teh sooner the patient gets help, the better.

[Guest]

I absolutely think dispatchers should be able to give instructions on this, however shouldn't people be shown by the prescribing doctor of pharmacist as to how to use it? Not that they won't forget in an emergency, but I would hope this is true.

[x242Steve 1]

For agencies using the National Academy EMD protocol, there is already a provision for asthma, bee stings and other known allergies, etc...

I don't have a card set in front of me, but you basically tell the caller or patient "If their/your doctor has instructed them/you to do something (a.k.a. take something, inject something...) in this situation, they/you may do it now."

Basically you are reminding them to think about what their doctor has already told them to do.

[Jybehofd 85]

Go for it.. more help the better isn't that what EMD was made for?

[NWFDMedic 58]

For agencies using the National Academy EMD protocol, there is already a provision for asthma, bee stings and other known allergies, etc...

I don't have a card set in front of me, but you basically tell the caller or patient "If their/your doctor has instructed them/you to do something (a.k.a. take something, inject something...) in this situation, they/you may do it now."

Basically you are reminding them to think about what their doctor has already told them to do.

Hopefully doctors will take the time to educate patients (and family for our special needs population. While the EMD card might allow for it, I do think they need to develop a canned set of directions to instruct the caller to administer the epi pen. I know that there were a good number of unintentional epi pen injections last summer... so what appears to us as idiot proof is not really.

[Remember585 815]

The PAIs of the EMD seem to change often to reflect the changes that EMTs can now do in the field. Off the top of my head I know we have the ability to tell a caller to "Do as the Doctor has instructed in these situations...." and "If they have a prescribed inhaler use it..." In the last protocol update, we are now able to give instructions that follow the line EMTs use to administer (assist) with aspirin.

It still amazes me there's agencies that choose not to have this tool to better help those in need.

[Guest Local596Secretary]

I see no reason why an EMD should be not able to do this. the only stipulation should be to inform the responding agency, department, rig etc., of the succesful injection or failure of injection. This would be helpful in allowing the emt/medic to expect the higher BP and Pulse rate that accompanies this injection. Of course, not all rigs carry thier own Epi pens. Therefore, the possiblity of a failed injection (slight chance of course) should be considered as now the patient would have to wait for a medic to arrive on scene before receving this life saving drug.

[SFRD49 8]

I am an EMD instructor for PowerPhone and we have had EpiPen pre-arrival instructions in our system since 2005. It's already in the protocols.

The system specifies "Do you (or the patient) have medication for it (allergic reaction)?" (If caller needs instructions on EpiPen, go to PROCEDURES Tab #6)".

I don't know if other EMD systems have this but we do.

Stay Safe,

SFRD49

[ny10570 745]

I've seen too many living people receive CPR and anxiety attacks or URIs receive ibuprofen, naproxen, and acetaminophen. These instruction are only as good as the information the CRO receives. GIGO, garbage in garbage out. At least in these cases there has been no real harm caused. You give epi to an 80 year old in ape you really could kill him. You give it in the wrong location and catch a vein (I know, its an outside shot) but again you've potentially done harm. How many Anaphylaxis patients are found in respiratory arrest by arriving EMS units? That would be easy enough to find out. Its time for fact based changes in EMS. Not just "ehh seems like a good idea."