Perspicacious, as ever. This an interesting and important Rubicon. It is the first treatment that
paramedics are being invited to administer that has the potential for harm. Until now,
administering drugs according to a set protocol, they were safe. Now, even if given entirely
appropriately and accurately, thrombolysis can kill a patient. There will be some psychological
fall out from this; doctors (and to a lesser extent nurses) are comfortable with the idea that their
treatment may do harm, as some are extremely harmful; anaesthesia, many anti-neoplastics,
much surgery and so on.
Paramedics have not yet been exposed to this, and I haven't yet seen an Ambulance Trust
incorporate discussion of handling death from treatment administered into the training for
thrombolysis.
> I am very concerned about the prospect of paramedics independently
> deciding=20
> to give a drug with such potentially negative consequences. How can
> they be=20
> sure that the patient does not have an aortic dissection? Or an active
> GIB?=20=
> Are=20
> they doing rectal exams in the field now too? What delay is there with
> that?
>
> I think that patients with chest pain SHOULD be treated like
> arrests/trauma=20
> when they arrive in the ED. Why aren't they? All it requires is some
> educati=
> on=20
> of the staff.=20
>
>
> Renee
>
>
Best wishes,
Rowley Cottingham
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