EMT

[Swoop411]

Forgot I posted in this thread. Here is the website I used to practice with. It was nice for that immediate feedback type result, as well as working your brain.

http://www.emtb.com/9e/assessment_in_action.cfm

[okiebill]

Forgot I posted in this thread. Here is the website I used to practice with. It was nice for that immediate feedback type result, as well as working your brain.

http://www.emtb.com/9e/assessment_in_action.cfm

Nice, Thanks Swoop


Tonight's class was 3 hours of review for the test on Thursday, I have a 400 question study guide I'm almost done with that the instructor says he will pull the majority of questions from. The first test should give me an idea on where my study habits need to be...LOL

[Swoop411]

The big difference is that I was only able to take the NY State EMT exam, I would have loved to take the NREMT exam and continue on to Paramedic. I passed, and averaged higher than most in the state, but have had difficulty landing a job here in the field. I have my name in the hat for some overseas gigs, we'll see how it goes. Anyways, good luck!

You and I are in the same boat! Several hundred dollars and several months later I got a nice shiny certificate for the wall, but no way of working in the field. I took the exam back in December, did on-site testing to get my results immediately, and was stoked. Its now June, nearly July, and I couldn't find a job within a reasonable drive of my home here. What sucks is not being able to advance to Paramedic because of not working as a Basic. Honestly at this point I would need to hit the books to refresh myself because it is definitely a skill that needs to be practiced frequently.

Didn't mean to clutter up your thread! DCAP-BTLS, Blue is bad-beer is good, warm wet and not yours don't touch it, if the pt is going to vomit turn them towards your partner, and I am sure I am forgetting a few gems!

[IANMCDEVITT]

Guys, just taking and passing the EMT is not a reason to continue to paramedic.

[IANMCDEVITT]

I agree it can be tough in some States to break into the field. Try to start by volunteering somewhere.

[okiebill]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

[Swoop411]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

Auto-injectors, Green and Yellow. Yellow is for adults and green is for kids.

Guys, just taking and passing the EMT is not a reason to continue to paramedic.

I agree it can be tough in some States to break into the field. Try to start by volunteering somewhere.

I originally wanted to go to school for paramedic, but a medic friend informed me that wasn't possible. Most of the local places want you to PAY to volunteer. I need money, why should I pay to donate my time? Retarded, they should at least pay me for my gas to get there if there is going to be a financial transaction.

[IANMCDEVITT]

Some volunteer squads do pay per call. Some have duty crews where they give you a stipend. That's not the object though, or should I say shouldn't be the object..........................PATIENT CONTACTS ARE THE OBJECT...........This next bit is for everyone............Sure, you can whisk right thru EMT-Basic or AEMT or whatever your state happens to offer but that ain't the true path.............trust me. Roll into the so called ËMS Room" (which is really an unused closet) in any local level one hospital and tell every smelly, tired, and underpaid medic sitting there you just went from EMT-Basic to Medic and they will literally treat you like you have Ebola. If you want to break into the field.......... PUT YOUR FRIGGIN TIME IN...........Is that so hard to comprehend ? If you don't want to volunteer outside the hospital, friggin volunteer inside the ER, meet the crews, get an ïn"to a company. Go further outside your area and find a company looking for EMT's. Drive a friggin wheeelchair van until you can break into the EMS side if you have too..............OK Rant off, sorry for the typing, I'm sitting in Angor Wat and the computer access sucks........BTW, you think I got to come here as Expedition Medic by skipping steps in this field and rushing to get my Medic ?........... Fucking think again.

[DannusMaximus]

I originally wanted to go to school for paramedic, but a medic friend informed me that wasn't possible.

Did he/she tell you why? I think you can go directly into a paramedic program through our local comm. college system, you get your EMT-B almost as an afterthought since you will have already earned it enroute to your para license. I could be wrong on that, I'm not a para and most of the folks on our contract amublance system get their paramedic school subsidized by AMR.

Some harsh truth

If you may want to do emergency medicine as a career, find a way to get patient contacts. As many as you can. There is simply no substitute for putting your hands on a patient and working with them. All the book learnin' in the world won't teach you how to calm somebody down, cowboy through the disgusting sights/sounds/smells that emergency medicine carries with it, or learn the tricks of the trade so essential to providing good pre-hospital care. Book learnin' is good, but patient contact is paramount. The abilty to keep your head and your ass wired together when things are a bit loopy cannot be taught but it can be learned by experience.

It is also important (IMHO) to have a mentor in this field, usually a senior medic, but really anybody with training and experience that can provide a steady hand and give you input. A senior para can give you guidance on what works, what doesn't, what you need to do in a real emergency and what you can let slide if you need to. Again, you can't learn that stuff from class, you have to learn it from another experienced person in the field.

This may mean you have to VOLUNTEER your time. Check your local Red Cross - - do they need additional help during blood drives? What about local nursing homes? CERT teams? Hospitals? If you have to pay to play (like use your own gas) then do so. Really.

I personally think getting a paramedic license is far too much time and effort unless you plan on working in the field full-time... and before you decide you want to to work in the field full-time you had better DAMN sure get some experience so you can see what it's like. I am continually shocked by how hard paramedics have to work for the pittance they're paid. A good paramedic is worth their weight in gold, and there are many in our AO who have learned to let the small shit roll off their backs and seem to genuinely like what they're doing. There are also many who are burned-out, cynical, and don't give a shit if a patient lives or dies. It's a hard career. Go into it with your eyes open.

[NYKh]

Thanks for all the good info on the EMT course!!

It’s a timely thread. I’ve just started with a local VFD and decided to focus on EMT/rescue first and then get into the suppression/FF1.
I’ll be starting my EMT class in mid August.

[IANMCDEVITT]

Brother, good for you. Your on the right path.

[Nalukai]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

this is my first post i just registered because i have been lurking for a long time on this site and i think its awesome. the reason I did finally register is that now im a NREMT-B i wanted to chime in on the new curriculum and try to help you out in a few ways since i passed my registry a few weeks ago. first off- that 7th drug you were thinking about is activated charcoal- it is per area protocol and the dosage is 1gram per kg body weight ( that is a registry test question) Epi is either .3 or .15 mg ( peds). yes you are right that this year it is an entirely new curriculum; but they really didnt merge AEMT with basic; its just some states now took away the EMT-I or AEMT now and made it either or basic or medic. this year curriculum is mostly focused on trauma ( previous ones were based off strokes etc. with medical) and assists with IVS and intubations /combitubes.... and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere. we worked out of the brady 12th edition book so im not sure what you are studying but on registry half my questions i got wasnt even in the book- i knew it from my instructors telling us in class and had stuff written down as side notes.the bulk of your registry exam this year is going to come from trauma, airway, and operations with focus on peds/signs and symptoms. you can PM me anytime and i will help you the best i can- so far out of day and night classes i was the top of them and the only one that has passed reg so far hehe.

[GP11]

and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere.

So my perspective is likely quite different from your, but I have to disagree with you on this. Trauma may seem complicated initially, but once you've been doing it for a while it's pretty straightforward--ABCDE, secondary survey, fluids, and transport to definitive care. Even in the emergency department it's not much different, just with more procedures and call the trauma surgeons.

On the other hand, you can spend a lifetime learning management of medical emergencies and you'll still regularly run across things you've never seen before.

[okiebill]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

this is my first post i just registered because i have been lurking for a long time on this site and i think its awesome. the reason I did finally register is that now im a NREMT-B i wanted to chime in on the new curriculum and try to help you out in a few ways since i passed my registry a few weeks ago. first off- that 7th drug you were thinking about is activated charcoal- it is per area protocol and the dosage is 1gram per kg body weight ( that is a registry test question) Epi is either .3 or .15 mg ( peds). yes you are right that this year it is an entirely new curriculum; but they really didnt merge AEMT with basic; its just some states now took away the EMT-I or AEMT now and made it either or basic or medic. this year curriculum is mostly focused on trauma ( previous ones were based off strokes etc. with medical) and assists with IVS and intubations /combitubes.... and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere. we worked out of the brady 12th edition book so im not sure what you are studying but on registry half my questions i got wasnt even in the book- i knew it from my instructors telling us in class and had stuff written down as side notes.the bulk of your registry exam this year is going to come from trauma, airway, and operations with focus on peds/signs and symptoms. you can PM me anytime and i will help you the best i can- so far out of day and night classes i was the top of them and the only one that has passed reg so far hehe.

Thanks for the heads up Nalukai

Yes Activated Charcoal was the last one though our instructor warned us it would probably get brick hard before you dispense any...lol


Tonight s class was over Chapter 8 (Assessment). We will spend about 6 hours of study on it from the book and lord knows how many hours from here on running scenarios.

,A question I had tonight:
"If Albuterol and Epi have the same action can I use one if I don't have the other in an emergency?"

[Nalukai]

and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere.

So my perspective is likely quite different from your, but I have to disagree with you on this. Trauma may seem complicated initially, but once you've been doing it for a while it's pretty straightforward--ABCDE, secondary survey, fluids, and transport to definitive care. Even in the emergency department it's not much different, just with more procedures and call the trauma surgeons.

On the other hand, you can spend a lifetime learning management of medical emergencies and you'll still regularly run across things you've never seen before.

I can agree on that. I was talking about the initial bookwork, not the actual physical aspect of it. I do realize that IRL medical would be much more of a pain because of the "detective" work involved, and the more you do it hands on the easier it becomes.

[rwiklund8]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

this is my first post i just registered because i have been lurking for a long time on this site and i think its awesome. the reason I did finally register is that now im a NREMT-B i wanted to chime in on the new curriculum and try to help you out in a few ways since i passed my registry a few weeks ago. first off- that 7th drug you were thinking about is activated charcoal- it is per area protocol and the dosage is 1gram per kg body weight ( that is a registry test question) Epi is either .3 or .15 mg ( peds). yes you are right that this year it is an entirely new curriculum; but they really didnt merge AEMT with basic; its just some states now took away the EMT-I or AEMT now and made it either or basic or medic. this year curriculum is mostly focused on trauma ( previous ones were based off strokes etc. with medical) and assists with IVS and intubations /combitubes.... and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere. we worked out of the brady 12th edition book so im not sure what you are studying but on registry half my questions i got wasnt even in the book- i knew it from my instructors telling us in class and had stuff written down as side notes.the bulk of your registry exam this year is going to come from trauma, airway, and operations with focus on peds/signs and symptoms. you can PM me anytime and i will help you the best i can- so far out of day and night classes i was the top of them and the only one that has passed reg so far hehe.

Thanks for the heads up Nalukai

Yes Activated Charcoal was the last one though our instructor warned us it would probably get brick hard before you dispense any...lol


Tonight s class was over Chapter 8 (Assessment). We will spend about 6 hours of study on it from the book and lord knows how many hours from here on running scenarios.

,A question I had tonight:
"If Albuterol and Epi have the same action can I use one if I don't have the other in an emergency?"

How do a bronchodilator and a vasoconstrictor have the same action? You could use albuteral for certain signs in anaphylaxis but albuteral won't reverse anaphylaxis like epi.

[BlueSilkRibbon]

First test down

It went Ok I scored an 88% (85% is passing). The fault was mine completely, One question I just did not know but the rest were all due to reading the question to quickly or not reading / missing a detail on the answers.

It is just as important to know how to test It has been a few years since I have been in a testing environment, the lessons are coming back to me...LOL

I passed so I guess it is OK in the long run but I'm a perfectionist.



After the test we started Pharmacology (Chapter 7) and started going through the Meds an EMT can dispense (The list is pretty small)

-O2
-Glucose
-Nitro
-Albuterol
-Asprin
-Epi
-I may be forgetting one...

Concerning Epinephrin: Our instructor started explaining dosages 1:10000 / milligrams per mL ect and had us scratching our heads so my hope is that it gets clarified next week.

this is my first post i just registered because i have been lurking for a long time on this site and i think its awesome. the reason I did finally register is that now im a NREMT-B i wanted to chime in on the new curriculum and try to help you out in a few ways since i passed my registry a few weeks ago. first off- that 7th drug you were thinking about is activated charcoal- it is per area protocol and the dosage is 1gram per kg body weight ( that is a registry test question) Epi is either .3 or .15 mg ( peds). yes you are right that this year it is an entirely new curriculum; but they really didnt merge AEMT with basic; its just some states now took away the EMT-I or AEMT now and made it either or basic or medic. this year curriculum is mostly focused on trauma ( previous ones were based off strokes etc. with medical) and assists with IVS and intubations /combitubes.... and i can tell you personally medical was easier than the trauma module. just a heads up for those ppl that took it before this year and said that trauma is patch and pack... its not that simple anymore- it is very detailed; there were very few ppl that passed trauma and they actually gave our module exam to the medic students before they started their block and 90 percent of them failed it- and they are mostly all currently working as basics somewhere. we worked out of the brady 12th edition book so im not sure what you are studying but on registry half my questions i got wasnt even in the book- i knew it from my instructors telling us in class and had stuff written down as side notes.the bulk of your registry exam this year is going to come from trauma, airway, and operations with focus on peds/signs and symptoms. you can PM me anytime and i will help you the best i can- so far out of day and night classes i was the top of them and the only one that has passed reg so far hehe.

Thanks for the heads up Nalukai

Yes Activated Charcoal was the last one though our instructor warned us it would probably get brick hard before you dispense any...lol


Tonight s class was over Chapter 8 (Assessment). We will spend about 6 hours of study on it from the book and lord knows how many hours from here on running scenarios.

,A question I had tonight:
"If Albuterol and Epi have the same action can I use one if I don't have the other in an emergency?"

How do a bronchodilator and a vasoconstrictor have the same action? You could use albuteral for certain signs in anaphylaxis but albuteral won't reverse anaphylaxis like epi.

They are both bronchodilators. Albuterol is primarily a beta-2 agent with small amount of alpha. Epinephrine is both alpha and beta.
quick pharm fact; alphas constrict and also speed up the the heart and beta's dilate. Beta-2 receptors are in the smooth muscles surrounding the bronchioles in the lungs. Epi would work but you get nasty side effects so we use as pure a beta agent as we can, in this case albuterol (an even better choice would be Xopenex (Leva-albuterol)
and yeah, we do use albuterol in bronchospasm caused by anaphalaxis along with steroids and two different kinds of antihistamines (H1&H2 blockers).

Strictly speaking, epinephrine is a an endogenous catacholamine sympathomimetic/vasoconstricter/bronchodilator

BSR

[Nalukai]

They are both bronchodilators. Albuterol is primarily a beta-2 agent with small amount of alpha. Epinephrine is both alpha and beta.
quick pharm fact; alphas constrict and also speed up the the heart and beta's dilate. Beta-2 receptors are in the smooth muscles surrounding the bronchioles in the lungs. Epi would work but you get nasty side effects so we use as pure a beta agent as we can, in this case albuterol (an even better choice would be Xopenex (Leva-albuterol)
and yeah, we do use albuterol in bronchospasm caused by anaphalaxis along with steroids and two different kinds of antihistamines (H1&H2 blockers).

Strictly speaking, epinephrine is a an endogenous catacholamine sympathomimetic/vasoconstricter/bronchodilator

BSR

yeah but you would need medical direction for that kind of intervention during anaphylaxis.... am i right? they are both bronchodilators but only EPI is a vasoconstrictor to increase cardiac output- which dilatation of the blood vessels is mostly the cause of anaphylaxis due to the histamines in the body. Albuterol would have little effect in that situation since it is absorbed through the lungs and not the bloodstream initially. It's obvious that you are medic level while im still a basic so i dont have the scope of practice nor the knowledge of beta 1-2 antogonists other than indications of use, but i love me some knowledge so please continue.....

[BlueSilkRibbon]

They are both bronchodilators. Albuterol is primarily a beta-2 agent with small amount of alpha. Epinephrine is both alpha and beta.
quick pharm fact; alphas constrict and also speed up the the heart and beta's dilate. Beta-2 receptors are in the smooth muscles surrounding the bronchioles in the lungs. Epi would work but you get nasty side effects so we use as pure a beta agent as we can, in this case albuterol (an even better choice would be Xopenex (Leva-albuterol)
and yeah, we do use albuterol in bronchospasm caused by anaphalaxis along with steroids and two different kinds of antihistamines (H1&H2 blockers).

Strictly speaking, epinephrine is a an endogenous catacholamine sympathomimetic/vasoconstricter/bronchodilator

BSR

yeah but you would need medical direction for that kind of intervention during anaphylaxis.... am i right? they are both bronchodilators but only EPI is a vasoconstrictor to increase cardiac output- which dilatation of the blood vessels is mostly the cause of anaphylaxis due to the histamines in the body. Albuterol would have little effect in that situation since it is absorbed through the lungs and not the bloodstream initially. It's obvious that you are medic level while im still a basic so i dont have the scope of practice nor the knowledge of beta 1-2 antogonists other than indications of use, but i love me some knowledge so please continue.....

Good questions but beyond the scope of this forum unless you have a few years of A&P, Chemistry, BioChemistry and Pharmacology.

Briefly:

Everything you give is under medical direction be it direct (online) or standing orders (offline).

The vasoconstriction property of epi is only a small piece of the increased cardiac output puzzle, The inotropic and chronotropic properties are equally if not more important. To much vasoconstriction is bad which is why we rarely use epi as an antihypotensive, we use nor-epinephrine (Levophed), phenylephrine (Neo-Synephrine) or dopamine (Intropine) and in certain cases dobutamine (Dobutrex).
Epi is used first in anaphalaxis because it works well, requires little training and can be given IM via autoinjector. Albuterol is used for constricted bronchioles not fixed by the epi because we dont want to give more epi. Frankly, BenadryI given fast enough can be all that is needed. I have seen people have massive myocardial infarctions after epi use because it vasoconstricts the coronary arteries as well.

I guess you could say I am at "the medic level"

BSR
RN,CEN,CCRN,CFRN
Air/Surface Critical Care Transport Nurse
http://WWW.ASTNA.ORG

[GP11]

The vasoconstriction property of epi is only a small piece of the increased cardiac output puzzle, The inotropic and chronotropic properties are equally if not more important. To much vasoconstriction is bad which is why we rarely use epi as an antihypotensive, we use nor-epinephrine (Levophed), phenylephrine (Neo-Synephrine) or dopamine (Intropine) and in certain cases dobutamine (Dobutrex)

Actually the reason that epi is rarely used as a pressor is that the vasocontrictive properties are frequently the desired effect, and you don't want the cardiac (especially the chronitropic) effects. That's why Levophed (alpha>beta-1) is the first pressor of choice in most shock situations rather than epinephrine (alpha=beta-1), and then the second pressor added is usually vasopressin (not a catecholamine, but purely vasocontrictive) or phenylephrine (pure alpha).

I have seen people have massive myocardial infarctions after epi use because it vasoconstricts the coronary arteries as well.

Coronary arteries contain primarily beta-2 receptors, so epi has a vasodilatory effect there. An MI after epi administration is more likely due simply to increased myocardial oxygen demand caused by the inotropic and chronotropic effects.

Edit: sorry about the thread hijack. I love pharmacology and critical care, so I can kind of geek out about this stuff.

[IANMCDEVITT]

Good info guys but slightly beyond Bill's needs. Bill keep us updated on how class is going.

[Nalukai]

Good info guys but slightly beyond Bill's needs. Bill keep us updated on how class is going.

agreed, but bill's gonna have to know the indications/contraindications of albuterol and epinephrine for class so all this extra information might just help out on a registry question... who knows whats gonna pop up on that thing.

@bluesilk i meant online medical direction to clarify; i know that offline are standing orders and such, sorry i wasnt specific but i get the drift

[GP11]

yeah but you would need medical direction for that kind of intervention during anaphylaxis.... am i right? they are both bronchodilators but only EPI is a vasoconstrictor to increase cardiac output- which dilatation of the blood vessels is mostly the cause of anaphylaxis due to the histamines in the body. Albuterol would have little effect in that situation since it is absorbed through the lungs and not the bloodstream initially. It's obvious that you are medic level while im still a basic so i dont have the scope of practice nor the knowledge of beta 1-2 antogonists other than indications of use, but i love me some knowledge so please continue.....

You have to remember there is no such thing as a molecule 100% specific for a certain receptor. Look at the side effects of albuterol--it is primarily beta-2, but also causes hypertension (alpha) and tachycardia (beta-1).

As regards the necessity of medical direction for the use of albuterol in anaphylaxis, it depends on your protocols. Obviously you need permission to deviate from your standing protocols, but albuterol for anaphylaxis is pretty standard (it was actually in our protocols for continued wheezing after epi where I practiced as a medic) and no doc is going to deny that request. In general, as long as they can tell you understand what you are doing and it sounds reasonable, most docs are pretty reasonable about med control requests in general.

[okiebill]

Thanks All

What actually brought the question about was my book has both Epi and Albuterol listed with the exact same action so my brain said OK you can use one if you don't have the other which is an oversimplification on my part...

I' m sure my questions will get tougher as class goes on, Its good to know that the expertise is around here that can answer questions in that much detail, simply amazing.

I skipped class Thursday to find the bottom of a bottle with an old friend I served with so along with the hangover I will be behind the curve this week...

Airway management starts next week (class is out this week due to a statewide EMT convention)

Such is life