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Working on protocols that utilize MAD, anyone have one/some they can share with

me? What drugs you are utilizing intranasal?

Has anyone ever considered a central website to upload protocols to?

I know many of us here often request other protocols to work off of, and we (or

at least I) always get the help I needed, but wouldn't it be simpler to have one

link, one site, one place to go to and be able to review hundreds of sets of

protocols?

Just food for thought

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

________________________________________________________________

Sent via the WebMail system at Neopolis.net

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>

> Working on protocols that utilize MAD, anyone have one/some they

can share with me? What drugs you are utilizing intranasal?

>

> Has anyone ever considered a central website to upload protocols to?

>

> I know many of us here often request other protocols to work off

of, and we (or at least I) always get the help I needed, but wouldn't

it be simpler to have one link, one site, one place to go to and be

able to review hundreds of sets of protocols?

>

> Just food for thought

> Hatfield FF/EMT-P

> www.canyonlakefire-ems.org

>

>

>. Here in the Panhandle under the PEMSS system Protocols we

give intranasal drugs via the MAD. They are Versed for seizures or

sedation, Narcan for Opiate OD, Glucagon for HYPOglyc, and topical

anesthetics and vasoconstrictors for nasal intubation, or tx of

epistaxis. These are really cool because you dont have to worry about

needle sticks to you. You have to atomize the IN meds across the

nasal mucosa though. Take a look at our PEMSS website for further

info. I think these are really cool,and easy to use..

Pat Dunaway EMT-P 441

Fritch EMS

>

>

>

> ________________________________________________________________

> Sent via the WebMail system at Neopolis.net

>

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FYI From Orange County Ambulance Service . Perhaps they will be of benefit

to you.

Claybar

M.A.D.® Medication Administration

Indications:

Lidocaine 4%: To reduce pain and gagging in patients requiring

nasogastric tubes or nasal

intubations

Midazolam: For treatment of persistent seizure activity

Naloxone: For use on patients suspected of opiate overdose

Procedure:

· Assess ABC’s – Airway, Breathing, Circulation

· For pulseless patients, proceed to ACLS guidelines

· Apply 100% oxygen NRB mask to seizing patient

· Apnea with pulse – Establish oral airway and begin bag

ventilation with 100% oxygen

· Assess weight: children weight in kg = 10+2(Age in years)

· Calculate appropriate medication dose (use dose from

corresponding protocol)

· Load syring with appropriate milliliter volume of medication and

attach MAD nasal atomizer

· Place atomizer 1.5 cm within the nostril, aiming at top of the

ipsilateral ear (slightly up and lateral)

· Briskly compress syringe to administer ½ of the volume as

atomized spray

· Remove and repeat in the other nostril, so all of the medication

is administered

· Continue ventilating patient as needed

Advantages of MAD

· The rich vascular plexus of the nasal cavity provides a direct route

into the blood stream for medication that easily cross mucous membranes.

· Due to direct absorption into the blood stream, gastrointestinal

destruction and hepatic first pass metabolism (destruction of drugs by the liver

enzymes) are avoided, allowing more drug to be bioavailable that if it were

administered orally.

· For many medications the rates of absorption and plasma

concentration are relatively comparable to that obtained by intravenous

administration.

· Ease and convenience: This method of drug administration is

essentially painless, does not require sterile technique, intravenous catheters

or other invasive devices and is immediately and readily available in all

patients.

· Due to the close proximity of the olfactory nasal mucousa to the

central nervous system, CSF drug concentrations may exceed plasma

concentrations, making this an attractive method of rapidly achieving adequate

CSF drug concentrations for centrally acting medications.

Hatfield wrote:

Working on protocols that utilize MAD, anyone have one/some they can

share with me? What drugs you are utilizing intranasal?

Has anyone ever considered a central website to upload protocols to?

I know many of us here often request other protocols to work off of, and we (or

at least I) always get the help I needed, but wouldn't it be simpler to have one

link, one site, one place to go to and be able to review hundreds of sets of

protocols?

Just food for thought

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

__________________________________________________________

Sent via the WebMail system at Neopolis.net

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

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>

> Has anyone ever considered a central website to upload protocols to?

>

I owuld be happy to host something like this on my site if people are

interested. Let me know and I will set something up.

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-that would be great to have an area just to go and check protocols or

policies

-- In texasems-l , " mayfieldr " wrote:

>

>

>

> >

> > Has anyone ever considered a central website to upload protocols to?

> >

>

> I owuld be happy to host something like this on my site if people are

> interested. Let me know and I will set something up.

>

>

>

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It's already made. It's called Google. :)

Mike :)

> ,

>

> I can host it, the question is, how many people would contribute, and

> how often would it be utilized?

>

> Mike

>

>

>

> Re: MAD

>

>

>

>>

>> Has anyone ever considered a central website to upload protocols to?

>>

>

> I owuld be happy to host something like this on my site if people are

> interested. Let me know and I will set something up.

>

>

>

>

>

>

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MADD devices are an excellent tool to use when an IV can not be established.

There are 3 meds that I know of that can be given intranasally. Versed, Narcan,

and Glucagon. Our company only uses it for versed and narcan and the normal

dose you give IV you would give IN. I was told that you had to use 2-3 mg of

glucagon. I'm not real sure....

Hatfield wrote: Verg on protocols that

utilize MAD, anyone have one/some they can share with me? What drugs you are

utilizing intranasal?

Has anyone ever considered a central website to upload protocols to?

I know many of us here often request other protocols to work off of, and we (or

at least I) always get the help I needed, but wouldn't it be simpler to have one

link, one site, one place to go to and be able to review hundreds of sets of

protocols?

Just food for thought

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

__________________________________________________________

Sent via the WebMail system at Neopolis.net

---------------------------------

We won't tell. Get more on shows you hate to love

(and love to hate): Yahoo! TV's Guilty Pleasures list.

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,

I can host it, the question is, how many people would contribute, and

how often would it be utilized?

Mike

Re: MAD

>

> Has anyone ever considered a central website to upload protocols to?

>

I owuld be happy to host something like this on my site if people are

interested. Let me know and I will set something up.

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Mike,

That's what I am trying to avoid. I wear a multitude of hats at my job,

and don't necessarily want to spend an inordinate amount of time sifting

through sites, and digging through crap to find what I need, and I

certainly don't want to reinvent the wheel.

One site, nothing but protocols from a variety of services, BLS, ALS,

MICU, transport and FR.

One stop shopping.

Besides, I don't like Google, Yahoo for me.:-)

Mike

Re: MAD

>

>

>

>>

>> Has anyone ever considered a central website to upload protocols to?

>>

>

> I owuld be happy to host something like this on my site if people are

> interested. Let me know and I will set something up.

>

>

>

>

>

>

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In a message dated 2/14/2007 10:33:00 P.M. Central Standard Time,

medic2562@... writes:

Our company only uses it for versed and narcan and the normal dose you give

IV you would give IN. I was told that you had to use 2-3 mg of glucagon. I'm

not real sure....

Fentanyl is also readily absorbed mucosally.

Grayson, CCEMT-P, etc.

_www.medictrainingsolutions.com_ (http://www.medictrainingsolutions.com/)

MEDIC Training Solutions

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