Re: Volunteer FF treating patients(Our finding)

[Guest guest]

In a message dated 02-Mar-06 13:18:18 Central Standard Time,

ExLngHrn@... writes:

Because oxygen is a prescription drug that should be administered by a

trained and/or certified provider.

I'm disappointed that a lawyer didn't know that there is a loophole in this

part of the prescription law...esp one who is an EMT-B and should have been

taught that loophole and the reasons for it....go back and search NFPA and your

Basic book and give me a 300 word essay please....

Similarly, coronary artery bypass graft operations are not a bad thing, but

they should be done by trained licensed professionals. *grin*

Ummm....I'm thinking that even with the consideration of hyperbole you just

followed your boots overboard!

Gene- your young acolyte needs a new pair of cement overshoes!

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:18:18 Central Standard Time,

ExLngHrn@... writes:

Because oxygen is a prescription drug that should be administered by a

trained and/or certified provider.

I'm disappointed that a lawyer didn't know that there is a loophole in this

part of the prescription law...esp one who is an EMT-B and should have been

taught that loophole and the reasons for it....go back and search NFPA and your

Basic book and give me a 300 word essay please....

Similarly, coronary artery bypass graft operations are not a bad thing, but

they should be done by trained licensed professionals. *grin*

Ummm....I'm thinking that even with the consideration of hyperbole you just

followed your boots overboard!

Gene- your young acolyte needs a new pair of cement overshoes!

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:23:37 Central Standard Time,

bbledsoe@... writes:

The oxygen extraction ratio for a healthy human is between 0.2 and 0.3

(20-30%). Thus, we have a large capacity to meet excess demand. This, or

course, diminishes with disease. So, instead of putting oxygen on a

12-year-old skateboarder with a Colle's fracture, save it for the

76-year-old with CHF. While oxygen is benign for the most part, there is

cost involved. It can add to an explosion hazard. It is uncomfortable at

high-flows and can dry out the mucous membranes causing dryness and

bleeding. So, back to the argument at hand: why use something that has very,

very little likelihood or benefiting the patient.

Agree on all points...but the original complaint gave no specifics as to why

he was upset with the use of Oxygen...It could have been something more

interesting like " High flow oxygen will ALWAYS make a COPD'er stop

breathing.... "

The bigger point is EMS people should problem solve and not simply use

cookbook protocols to treat every patient. It takes humans for the former

and simians could do the latter.

Actually, Chimps are pretty innovative...at least when it comes to making

tools to find food...

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:23:37 Central Standard Time,

bbledsoe@... writes:

The oxygen extraction ratio for a healthy human is between 0.2 and 0.3

(20-30%). Thus, we have a large capacity to meet excess demand. This, or

course, diminishes with disease. So, instead of putting oxygen on a

12-year-old skateboarder with a Colle's fracture, save it for the

76-year-old with CHF. While oxygen is benign for the most part, there is

cost involved. It can add to an explosion hazard. It is uncomfortable at

high-flows and can dry out the mucous membranes causing dryness and

bleeding. So, back to the argument at hand: why use something that has very,

very little likelihood or benefiting the patient.

Agree on all points...but the original complaint gave no specifics as to why

he was upset with the use of Oxygen...It could have been something more

interesting like " High flow oxygen will ALWAYS make a COPD'er stop

breathing.... "

The bigger point is EMS people should problem solve and not simply use

cookbook protocols to treat every patient. It takes humans for the former

and simians could do the latter.

Actually, Chimps are pretty innovative...at least when it comes to making

tools to find food...

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:37:34 Central Standard Time,

lnmolino@... writes:

Not even the FDA says that. They have a provision for " emergency O2 Units "

sadly they are low flow type units like LifeOgen but they are common in

sporting like SCUBA and they require no prescription to buy and or use.

While the 'low flow units' that used to be sold had limited functionality (I

believe that they were generally 6 lpm simple mask with about a 20 minute

capacity and about the size of a 16 oz propane tank), the deal worked out

between the NFPA, the Compressed Gas Assocation and the US FDA is actually a

bit

more complex than that...

and covers essentially *EVERY* use of oxygen under emergency

circumstances...the only real regulation by the FDA is for devices designed to

consistently

deliver less than 5 liters of breathing oxygen per minute! And naturally,

those are the ones most often found 'in home' being abused by folks who

continue

to smoke...

All of your high flow devices are FDA approved, but regulated by the CGA for

all intents and purposes...

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:37:34 Central Standard Time,

lnmolino@... writes:

Not even the FDA says that. They have a provision for " emergency O2 Units "

sadly they are low flow type units like LifeOgen but they are common in

sporting like SCUBA and they require no prescription to buy and or use.

While the 'low flow units' that used to be sold had limited functionality (I

believe that they were generally 6 lpm simple mask with about a 20 minute

capacity and about the size of a 16 oz propane tank), the deal worked out

between the NFPA, the Compressed Gas Assocation and the US FDA is actually a

bit

more complex than that...

and covers essentially *EVERY* use of oxygen under emergency

circumstances...the only real regulation by the FDA is for devices designed to

consistently

deliver less than 5 liters of breathing oxygen per minute! And naturally,

those are the ones most often found 'in home' being abused by folks who

continue

to smoke...

All of your high flow devices are FDA approved, but regulated by the CGA for

all intents and purposes...

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:37:57 Central Standard Time,

firedawg_2445@... writes:

The original post does'nt mention getting talked to about

administering oxygen, It talked about administering Albuterol.

Most of us are responding to Mr. Barber's complaint about:

Here is a similiar wrinkle that we have discovered. We have a volunteer

Fire Figher that places patients on Oxygen routinely prior to our

arrival. After several conversations with the state we have been

informed that there is nothing that we can do to stop them. Even if we

pull our affiliation with the organization and they loose their first

responder status, this individual or anyone else in their department can

continue to do as they please.

No teeth in the First Responder Rules. Sponsoring transport agencies

really have no control over the First Responder.

Henry

S. Krin, DO FAAFP

[Guest guest]

In a message dated 02-Mar-06 13:37:57 Central Standard Time,

firedawg_2445@... writes:

The original post does'nt mention getting talked to about

administering oxygen, It talked about administering Albuterol.

Most of us are responding to Mr. Barber's complaint about:

Here is a similiar wrinkle that we have discovered. We have a volunteer

Fire Figher that places patients on Oxygen routinely prior to our

arrival. After several conversations with the state we have been

informed that there is nothing that we can do to stop them. Even if we

pull our affiliation with the organization and they loose their first

responder status, this individual or anyone else in their department can

continue to do as they please.

No teeth in the First Responder Rules. Sponsoring transport agencies

really have no control over the First Responder.

Henry

S. Krin, DO FAAFP

[Guest guest]

Basically what I was told today is that TDSHS cannot

prevent the FDs from using oxygen, AEDs, etc without a

protocol or medical direction, however liability wise

it's in the city's best interest. The FRO can have

their own protocol an medical direction but they must

still have a joint agreement signed between the

medical directors.

Salvador Capuchino Jr

EMT-P/Vol. FF

--- Henry wrote:

>

>

> Here is a similiar wrinkle that we have discovered.

> We have a volunteer

> Fire Figher that places patients on Oxygen routinely

> prior to our

> arrival. After several conversations with the state

> we have been

> informed that there is nothing that we can do to

> stop them. Even if we

> pull our affiliation with the organization and they

> loose their first

> responder status, this individual or anyone else in

> their department can

> continue to do as they please.

>

> No teeth in the First Responder Rules. Sponsoring

> transport agencies

> really have no control over the First Responder.

>

>

> Henry

>

>

>

>

>

>

[Guest guest]

To answer your question we are requested by the EMS agency to respond.

Sometimes the calls come in through the PD and we get toned out to respond e.g.,

MVCs. We cover a large rural area.

Salvador Capuchino Jr

EMT-P/Vol. FF

--- Danny wrote:

> So I would take it that the Fire Fighter is not a

> trained/Certified EMT? Why are the fire fighters

> responding if they are not contacted by someone?

>

> So many questions. So few answers.

>

> ExLngHrn@... wrote:

> Because oxygen is a prescription drug that should

> be administered by a trained and/or certified

> provider. Similarly, coronary artery bypass graft

> operations are not a bad thing, but they should be

> done by trained licensed professionals. *grin*

>

> -Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> Re: Volunteer FF treating

> patients(Our finding)

>

>

> Perhaps I have missed something. Why would putting a

> patient on oxygen be a bad

> thing?

>

> Henry wrote:

>

> Here is a similiar wrinkle that we have discovered.

> We have a volunteer

> Fire Figher that places patients on Oxygen routinely

> prior to our

> arrival. After several conversations with the state

> we have been

> informed that there is nothing that we can do to

> stop them. Even if we

> pull our affiliation with the organization and they

> loose their first

> responder status, this individual or anyone else in

> their department can

> continue to do as they please.

>

> No teeth in the First Responder Rules. Sponsoring

> transport agencies

> really have no control over the First Responder.

>

>

> Henry

>

>

>

>

>

>