83 replies to this topic

[Chris07]

EMT here, I would add Epinephrine (Auto injector obviously) and Albuterol. I haven't heard of too many EMT-Bs administering Tylenol, at least around here lol. I'm not sure if you're adding "emt-assisted" medications. 

 

Would add Ipratropium Bromide, Midazolam, Promethazine, Diphenhydramine, Hydroxycobalamin (I think it's used for smoke inhalation) for the paramedic. Sorry if I added anything you already have.

 

Will you be doing RSI in this? Would be cool to add the full sequence, pretreatment, sedation, paralytics then post sedation and analgesia. 

Yea EMT-assisted meds are implied and include Albuterol via MDI, Epinephrine via Autoinjector, and Nitroglycerine if the patient has them. Still trying to figure out how to make that work in the game. I may just leave it out for simplicity.

 

I was considering Ipratropium Bromide (Atrovent) but locally it's not something our ALS carry. I think I'll throw it in.

Midazolam = Versed, Diphenhydramine = Benadryl. I chose Zofran over Promethazine since it's more common around here. Plus both are used in the same circumstances. No need for redundancy.

 

I thought about doing RSI but maybe not. RSI is sort of a "Holy Grail" skill that isn't very common.

 

Tylenol is often used in systems that have extended transport times for use on young children with fevers. I may bump it up to AEMT.

 

Hydroxycobalamin is used to treat cyanide poisoning. Might be useful for use on smoke inhalation calls.

[RangerDog]

The XP system idea sounds great, mayby you even have to start as a sort of assitent? (In the Netherlands the driver dont know from america.)

[CFDDIVE11]

XP system is excellent! And will you make a drug guide for people that don't know what each drug does

[Chris07]

XP system is excellent! And will you make a drug guide for people that don't know what each drug does

Of course. There will be a drug guide.

The XP system idea sounds great, mayby you even have to start as a sort of assitent? (In the Netherlands the driver dont know from america.)

Typically here the driver is trained at least to the EMT level.

Initially everyone will be EMT except for one character who will be a Paramedic. Technically you can upgrade everyone to paramedic but it would get more expensive since the cost to promote increases with the number of paramedics you have.

[RangerDog]

So you can have more paramedics?

[Chris07]

Yes, but you have to get them through upgrades by spending XP.

[erfd]

We RSI often where I work, fortunate to have very skilled medics and EMT partners,

 

Where I'm from we have EMR, EMT, and Paramedics.

 

EMTs can:

- Peripheral IV insertion 

- EZ-IO administration 

- Administration of the following medication: 

- EpiPen and EpiPen Jr. (IM/subcutaneous) 

- Nitroglycerin spray (SL) 

- Albuterol nebulization 

- Oxygen therapy 

- Glucagon (IM/subcutaneous) 

- Benadryl (Oral) 

- Use of the semi automatic defibrillator LifePak15

- Lucas Device 

- Cardiac monitor application (including 12 lead) Rhythms strips are to be 

confirmed by Paramedic/RN/MD 

- Provide initial treatment for anaphylaxis 

- Provide oxygen therapy 

- Provide fracture immobilization 

- Airway adjuncts: oral/nasal or KING airway 

- Initial burn management 

- Initial treatment of the medically unstable patient 

- Initial management of the trauma patient 

- Apply CAT Tourniquet 

- Response to multiple casualty incidents 

- Response to Hazardous Materials incidents 

 

Paramedic Medications:

 Adenosine (Adenocard)

 Lopressor

 Albuterol (Proventil, Ventolin) premixed for nebulization - 2.5 mg

 Lorazepam (Ativan)

 Aspirin (ASA)

 Magnesium Sulfate

 Atropine

 Midazolam HCL (Versed)

 Calcium Chloride 10%

 Naloxone (Narcan)

 Cardizem (Diltiazem)

 Nitroglycerin tablets or spray 0.4 mg (grains 1/150)

 Dilaudid

 Nitroglycerin IV gtt

 DuoDote

 Ondansetron (Zofran)

 Duo Neb

 Oral Glucose (Reactose, others)

 Dextrose 50%

 Oxygen

 Diphenhydramine HCL (Benadryl)

 Proparacaine HCL (Tetracaine) [or equivalent]

 Epinephrine 1:1000 and 1:10,000

 Racemic Epi Neb

 Etomidate (Amidate)

 Sodium Bicarbonate

 Fentanyl

 Succinylcholine (Anectine)

 Furosemide (Lasix)

 Terbutaline Sulfate (Brethine)

 Glucagon

 Toradol (Ketorolac)

 Haloperidol (Haldol)

 Vecuronium (Norcuron)

 Ketamine

 Zofran

 

I'd like to see the fire department first respond to all medicals except for psych in nature.

[randomperson139]

I like the idea of this, good luck!

 

We RSI often where I work, fortunate to have very skilled medics and EMT partners,

Really? We can't do RSIs over here, it's a skill purely for the Doctors at the moment.

[erfd]

I like the idea of this, good luck!

 

Really? We can't do RSIs over here, it's a skill purely for the Doctors at the moment.

That's surprising! Yeah, when I started at my current service I was surprised how often they do it compared to some surrounding services. It is great to be able to do when you have a patient that is very distressed, and really nice for unconscious people with clamped down jaws that need an advanced airway.

[randomperson139]

That's surprising! Yeah, when I started at my current service I was surprised how often they do it compared to some surrounding services. It is great to be able to do when you have a patient that is very distressed, and really nice for unconscious people with clamped down jaws that need an advanced airway.

The issue over here is more lack of use for skills like that. It wouldn't be used often enough.

When it comes to advanced airways, endotracheal intubation on its own is another thing that is probably normal over there. Whereas over here, trusts aren't allowing it any more for new Paramedics.

 

Anyway, this is kinds going off topic. A topic in the Off-Topic section may be an idea if you're interested in what we can/can't do in different countries. There must be other Medical staff on here.

[Chris07]

erfd, Minnesota is one of a very few places that has incredibly liberal protocols. There are a lot of rural locations and transport times can be long, thus the need for those skill sets. RSI and even surgical airways are far from the norm in the rest of the country....which I why I will include them.

[WHFD ENGINE 23]

Hows the mod coming along?

[Chris07]

Still in planning phase. I'm waiting to see what EM5 offers before I begin actual production.

[erfd]

erfd, Minnesota is one of a very few places that has incredibly liberal protocols. There are a lot of rural locations and transport times can be long, thus the need for those skill sets. RSI and even surgical airways are far from the norm in the rest of the country....which I why I will include them.

True, I guess I don't know much about rural EMS, I've always worked in the metro or suburbs. Our local doctors found much better outcomes in patient care allowing advanced prehospital care interventions. Even if only 5-10 minutes away from the hospital, we can get critical care started.

 

We used to have all the different levels (Basic, I, A, Medics, etc.) but it was decided it was better for patient care if all providers were trained to advanced levels and allowed more versatile use of Medic/EMT trucks. It allows much better flow on critical calls to, to be able have the EMT do the IV/IO, start cardiac monitoring, etc. while the medic prepares performs other advanced procedures as needed, as well as allow EMTs to take more of the transports to allow medics to get more breaks and drive instead of being bombarded by transports.

 

It also allows non-transport fire and other EMT first responders to apply early use of basic, but important medication and start IVs for the EMS crew before arrival.

 

Overall works great for the providers and patients, at least in our area.

[Chris07]

Anyone have an idea on a service name for the paramedic ambulance company you will be playing as?

The current name I'm thinking of:

 

Northview Emergency Medical Services Authority - NEMSA

 

 

The name has to describe the service, which the above does. The ambulance provider is the medical authority in the EMS system. While some Fire Departments have Paramedics, whenever the ambulance paramedics show up, they are in charge. (Hence my desire to have the word "Authority" in the name although it is not required).

While the company is not "Government-run" it is a contracted "not-for-profit" organization. Also, the company is the exclusive ambulance provider for the county, with the exception of a few larger cities who use their local fire department as their ambulance provider. The county is diverse ranging from urban to suburban to downright rural.

Any other ideas for names or do you guys like that?

[erfd]

I like simpler names like Northview Paramedics, Northview Ambulance, Northview Advanced Life Support Ambulance, Northview County Ambulance, etc.

[Fred03]

Northview EMS. Keep it short, keep it simple. Long names invariably get shortened in common speak anyway and something can have authority without having the word "authority" in the name. Example the "Northview Fire Department" would have jurisdiction over fire scenes but the name isn't the "Northview Fire Authority".

[Chris07]

How about Regional Ambulance Service? Or Maybe Regional Emergency Medical Services (REMS for short)

[rcmp123]

RAS seems good to me (Regional Ambulance Service)

[rescue_nerd]

The concept is great but I imagine it would take a huge amount of time and skills to create such a mod.