my EMS trained friends: now hear this!
Jul. 16th, 2007 11:33 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drewkittyDo you know someone with allergies? Add this to your jump kits immediately.
Benadryl is now available in a form other than liquid and oral.
oral strips
Benadryl oral strips
If you've ever had to manage a life-threatening allergic reaction . . . now we have an even better tool.
The recommended dosage is 50 to 75 mg, or 2 to 3 strips, for an adult patient.
From http://www.emedicine.com/EMERG/topic55.htm
Prehospital Care:
* Prehospital care must assess severity immediately and provide immediate appropriate treatment, because the most endangered patients die within 30 minutes of a sting.
* Local reactions can be life threatening if swelling occludes the airway. Initiate invasive measures to secure the airway if this occurs. Otherwise, the following local care measures suffice:
* Diphenhydramine limits the size of the local reaction.
* Clean wound and remove stinger if present.
* Apply ice or cool packs.
* Elevate extremity to limit edema.
* Manage generalized reactions similarly to anaphylaxis, even in the absence of shock. Check airway and ventilatory status. Treatment should include an initial intravenous (IV) bolus of 10-20 mL/kg isotonic crystalloids in addition to diphenhydramine and epinephrine.
* If the patient has not removed the stinger, it should be removed as soon as possible by the first caregiver on the scene. Delay increases venom load, so the fastest removal technique is the best. Pinching and traction is an acceptable technique.
Protocol Analysis:
Your local protocols will vary. This is an intervention I would unhesitatingly apply to myself, a friend or a family member. However, functioning in the context of an EMS agency, it is not clear that protocols would support this lifesaving treatment. Clearly this is something that potential patients should carry and self-administer.
Santa Clara County EMSA
From Routine Medical Care: Adult Section 2.6
Patient Medications
o Field personnel should make a list of the patient’s medication(s), including the drug name, dose, and frequency, and/or bring the medication bottle(s) with the patient to the hospital.
o BLS personnel may allow the patient to take his/her own medication; however, the patient must be alert enough to self-administer the medication. In most cases, these medications should only include: Nitroglycerine (if SBP >= 90 mmHg), anaphylaxis kit drugs, and metered dose
inhalers. emphasis added
Santa Cruz County EMSA Protocols.
M2: Acute Allergic Reaction allows only for life threats care and transfer of care. Per the county Drug List, BLS is not authorized to administer Benadryl, which is listed as an IVP or IM only. (In other words, no provision for oral administration.)
American Red Cross First Aid Station Team Protocols
not mentioned, therefore not authorized -- although we carry Benadryl oral as a self-administration medication
Credit http://cerulean-me.livejournal.com/563335.html via http://mactavish.livejournal.com/5427481.html
Benadryl is now available in a form other than liquid and oral.
oral strips
Benadryl oral strips
If you've ever had to manage a life-threatening allergic reaction . . . now we have an even better tool.
The recommended dosage is 50 to 75 mg, or 2 to 3 strips, for an adult patient.
From http://www.emedicine.com/EMERG/topic55.htm
Prehospital Care:
* Prehospital care must assess severity immediately and provide immediate appropriate treatment, because the most endangered patients die within 30 minutes of a sting.
* Local reactions can be life threatening if swelling occludes the airway. Initiate invasive measures to secure the airway if this occurs. Otherwise, the following local care measures suffice:
* Diphenhydramine limits the size of the local reaction.
* Clean wound and remove stinger if present.
* Apply ice or cool packs.
* Elevate extremity to limit edema.
* Manage generalized reactions similarly to anaphylaxis, even in the absence of shock. Check airway and ventilatory status. Treatment should include an initial intravenous (IV) bolus of 10-20 mL/kg isotonic crystalloids in addition to diphenhydramine and epinephrine.
* If the patient has not removed the stinger, it should be removed as soon as possible by the first caregiver on the scene. Delay increases venom load, so the fastest removal technique is the best. Pinching and traction is an acceptable technique.
Protocol Analysis:
Your local protocols will vary. This is an intervention I would unhesitatingly apply to myself, a friend or a family member. However, functioning in the context of an EMS agency, it is not clear that protocols would support this lifesaving treatment. Clearly this is something that potential patients should carry and self-administer.
Santa Clara County EMSA
From Routine Medical Care: Adult Section 2.6
Patient Medications
o Field personnel should make a list of the patient’s medication(s), including the drug name, dose, and frequency, and/or bring the medication bottle(s) with the patient to the hospital.
o BLS personnel may allow the patient to take his/her own medication; however, the patient must be alert enough to self-administer the medication. In most cases, these medications should only include: Nitroglycerine (if SBP >= 90 mmHg), anaphylaxis kit drugs, and metered dose
inhalers. emphasis added
Santa Cruz County EMSA Protocols.
M2: Acute Allergic Reaction allows only for life threats care and transfer of care. Per the county Drug List, BLS is not authorized to administer Benadryl, which is listed as an IVP or IM only. (In other words, no provision for oral administration.)
American Red Cross First Aid Station Team Protocols
not mentioned, therefore not authorized -- although we carry Benadryl oral as a self-administration medication
Credit http://cerulean-me.livejournal.com/563335.html via http://mactavish.livejournal.com/5427481.html
