Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 Just getting home and settled from attending a hearing on this Bill (HB 2827) and finishing a report. I saw this post and I thought I'd share with you that there are other areas of the Health and safety code which have to be addressed, look at section 773.014. I think Rep. will work on a possible revision/replacement/amendment or something to this bill. Representative presented the bill and there was only one person there to testify, (well it was late) she was for the bill and she made an impression on the committee. Good Night/Morning. I feel like I'm back on the ambulance. Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > Author: > > A BILL TO BE ENTITLED > > 1 AN ACT > > 2 relating to rules regarding anaphylaxis treatment provided by > > 3 emergency medical services personnel. > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > 6 amended by adding Subsection (g) to read as follows: > > 7 (g) Rules adopting minimum standards under this section > > 8 shall require: > > 9 (1) an emergency medical services vehicle to be > > 10 equipped with an epinephrine injector or similar device to treat > > 11 anaphylaxis; and > > 12 (2) emergency medical services personnel to complete > > 13 continuing education training in the administration of anaphylaxis > > 14 treatment. > > 15 SECTION 2. This Act takes effect immediately if it receives > > 16 a vote of two-thirds of all the members elected to each house, as > > 17 provided by Section 39, Article III, Texas Constitution. If this > > 18 Act does not receive the vote necessary for immediate effect, this > > 19 Act takes effect September 1, 2007. > > E. Bledsoe, DO, FACEP > > Midlothian, Texas > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 In a message dated 4/4/2007 11:07:31 PM Central Daylight Time, wegandy1938@... writes: Would it be beyond the pale to consider showing EMTs how to give a subcutaneous injection and just carrying syringes and epi ampules? That would save lots of money. Just what is it about wearing a different colored patch that miraculously makes one suddenly able to learn how to give a simple injection? part of the deal, Gene, is the difference in speed of treatment. I believe that studies have shown that inexperienced providers and parents average around 120-140 seconds to recognize, prepare and inject from ampoules, experienced providers 'only' need around 60 seconds to recognize, prepare and inject from ampoules, and the AutoInjectors cut that time to around 20-30 seconds... Add in the need to clear the clothing from the area if you are using either the ampule/syringe or the AnaKit type 'three dose' syringe verses the ability to 'stab and jab' through clothing with the AutoInjector, and you may have enough of a speed benefit to justify the additional cost for folks with truly life threatening allergies. ck S. Krin, DO FAAFP ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 In a message dated 4/5/2007 10:06:28 A.M. Central Daylight Time, west_tx_firefighter@... writes: What would we do with an acute pt other than watch a horrible death? And that is the point. While Epi and any drug can hurt and even kill if used wrong with good training, properly defined protocols and the like the vast majority of folks that would get Epi via an EMT-B or even a FR would be in NEED of that Epi and like opening an airway or using an AED this is a skill that can and likely will save lives. Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant LNMolino@... (Cell Phone) (IFW/TFW/FSS Office) (IFW/TFW/FSS Fax) " A Texan with a Jersey Attitude " " Great minds discuss ideas; Average minds discuss events; Small minds discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 In a message dated 4/4/2007 11:06:56 P.M. Central Daylight Time, wegandy1938@... writes: Would it be beyond the pale to consider showing EMTs how to give a subcutaneous injection and just carrying syringes and epi ampules? That would save lots of money. we did just that at McGuire AFB when I was there prior to coming to Texas. We had an issue with doing that with our CIV EMT's as we knew we'd be outside the NJ Scope of Practice for EMT-B's to 1) give Epi to a person without a script for same and 2) the whole draw up thing and needle were a HUGE issue there. We were able to do the " while on the DOD property you could do thins but not beyond the fence line. On at least one occasion we did just that stopped the truck just shy of the gate did the SQ injection and transported to the CIV off base hospital, in that case I am 110% positive the drug was a major factor in the patient NOT going in to full respiratory arrest! Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant LNMolino@... (Cell Phone) (IFW/TFW/FSS Office) (IFW/TFW/FSS Fax) " A Texan with a Jersey Attitude " " Great minds discuss ideas; Average minds discuss events; Small minds discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) The comments contained in this E-mail are the opinions of the author and the author alone. I in no way ever intend to speak for any person or organization that I am in any way whatsoever involved or associated with unless I specifically state that I am doing so. Further this E-mail is intended only for its stated recipient and may contain private and or confidential materials retransmission is strictly prohibited unless placed in the public domain by the original author. ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 Gene, Our medical director allows basics to do just that, draw it up and inject, less than $5 compared to epi pen $60. It's not brain surgery a few minutes extra training and amazingly us basics can use a syringe, who would think it possible. Renny EMT-B Almost finished EMT-I student Grammatical error.. > > > > " We would be better served directing our legislature down the road we > > need to be taking, rather than the legislature assuming it needs to > > direct us. We should know better " > > > > My apologies to the learned members of the list. > > > > 'Huuked on foniks werked fer me' Hatfield > > > > New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 Since I'm currently taking an Intermediate/Paramedic course, I'd like to throw one thought into this discussion. Whenever we add something to the protocols, particularly at the basic and intermediate levels, we should ensure that we not only teach the skill, but the pathophysiology and the rationale behind the skill. We need to encourage thinking and recognition of medical emergencies, not just the ability to perform a skill. A CE course for EMTs on how to administer a shot of epinephrine is a lot less admirable than a CE on allergic reactions culminating in recognizing allergic reactions, including anaphalyctic shock -- and administering oral diphenhydramine or an Epi-Pen (or SQ epinephrine) shot. -Wes Ogilvie, MPA, JD, EMT Attorney at Law/Emergency Medical Technician/Paramedic Student Austin, Texas New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 That makes sense. GG > > > In a message dated 4/4/2007 11:07:31 PM Central Daylight Time, > wegandy1938@wegandy writes: > > Would it be beyond the pale to consider showing EMTs how to give a > subcutaneous injection and just carrying syringes and epi ampules? That > would save > lots of money. > > Just what is it about wearing a different colored patch that miraculously > makes one suddenly able to learn how to give a simple injection? > > part of the deal, Gene, is the difference in speed of treatment. I believe > that studies have shown that inexperienced providers and parents average > around > 120-140 seconds to recognize, prepare and inject from ampoules, experienced > providers 'only' need around 60 seconds to recognize, prepare and inject > from ampoules, and the AutoInjectors cut that time to around 20-30 > seconds... > > Add in the need to clear the clothing from the area if you are using either > the ampule/syringe or the AnaKit type 'three dose' syringe verses the > ability > to 'stab and jab' through clothing with the AutoInjector, and you may have > enough of a speed benefit to justify the additional cost for folks with > truly > life threatening allergies. > > ck > S. Krin, DO FAAFP > > ************ ******** ******** ************<wbr>*********http://www.aol.http > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 I dont think the question should be that EMT B's be allowed accross the board to draw up epi and inject vs epi pens. That should be one for the medical director and local service. I would be inclined to think that an accross the board thing would lead to " well they can inject epi... why not narcan or d50 or this or that " While as a Basic I personally wouldnt mind getting to do more advanced procedures, I know some who dont pursue a Red patch because they dont want to do these things. I also thnk that it would detract from the paramedic status. ( I dont want yall to think I worship red patches but reconize the differences in the level of education ) I do think that every truck, BLS or ALS, should have to have some means of delivery for epi. If we want to provide adequate care for our pts than why not carry it and make it an allowable drug for even basics to administer vs " only if its the persons own perscribbed med " . I have been in west tx on several africanized bee sting responses both on an ambulance and in other capacities. It always made me a little reluctant to go since we didnt have to carry epi pens in a bls truck and didnt because of it. What would we do with an acute pt other than watch a horrible death? No I think the idea is a good one but in practice it needs to be a bit more thought out as far as requiring one or the other. Im sure you will, but let me know if my ramblings even make sense lol. ez FF / EMT B spenair wrote: Gene, Our medical director allows basics to do just that, draw it up and inject, less than $5 compared to epi pen $60. It's not brain surgery a few minutes extra training and amazingly us basics can use a syringe, who would think it possible. Renny EMT-B Almost finished EMT-I student Grammatical error.. > > > > " We would be better served directing our legislature down the road we > > need to be taking, rather than the legislature assuming it needs to > > direct us. We should know better " > > > > My apologies to the learned members of the list. > > > > 'Huuked on foniks werked fer me' Hatfield > > > > New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 This is the problem when you start legislating what EMS can and should do. Does anyone here think that the California model of legislatively defined scope of practice produces better medical care than does our Texas model of delegated practice from the medical director? What works in Terlingua may not work in Houston. Uniformity and consistency aren't always the panacea. Just remember, Mc's is uniform and consistent. -Wes Ogilvie New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 I very much agree. This should be a medical issue. This is why most EMS physicians and the TAA are against this. BEB From: texasems-l [mailto:texasems-l ] On Behalf Of ExLngHrn@... Sent: Thursday, April 05, 2007 10:10 AM To: texasems-l Subject: Re: Re: New Bill This is the problem when you start legislating what EMS can and should do. Does anyone here think that the California model of legislatively defined scope of practice produces better medical care than does our Texas model of delegated practice from the medical director? What works in Terlingua may not work in Houston. Uniformity and consistency aren't always the panacea. Just remember, Mc's is uniform and consistent. -Wes Ogilvie New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 I'd like to throw out a thought for consideration regarding this. Does requiring this specific piece of equipment for this specific use start us toward a scope of practice? Eddie , EMT-P Director of Clinical Services 4100 Ed Bluestein Blvd., Suite 100 Austin, TX 78721 ext. 110 _____ From: texasems-l [mailto:texasems-l ] On Behalf Of ExLngHrn@... Sent: Thursday, April 05, 2007 9:48 AM To: texasems-l Subject: Re: Re: New Bill Since I'm currently taking an Intermediate/Paramedic course, I'd like to throw one thought into this discussion. Whenever we add something to the protocols, particularly at the basic and intermediate levels, we should ensure that we not only teach the skill, but the pathophysiology and the rationale behind the skill. We need to encourage thinking and recognition of medical emergencies, not just the ability to perform a skill. A CE course for EMTs on how to administer a shot of epinephrine is a lot less admirable than a CE on allergic reactions culminating in recognizing allergic reactions, including anaphalyctic shock -- and administering oral diphenhydramine or an Epi-Pen (or SQ epinephrine) shot. -Wes Ogilvie, MPA, JD, EMT Attorney at Law/Emergency Medical Technician/Paramedic Student Austin, Texas New Bill > > > > Bill Number: TX80RHB 2827 Filed: 03-07-2007 > > > > Author: > > > > A BILL TO BE ENTITLED > > > > 1 AN ACT > > > > 2 relating to rules regarding anaphylaxis treatment provided by > > > > 3 emergency medical services personnel. > > > > 4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: > > > > 5 SECTION 1. Section 773.050, Health and Safety Code, is > > > > 6 amended by adding Subsection (g) to read as follows: > > > > 7 (g) Rules adopting minimum standards under this section > > > > 8 shall require: > > > > 9 (1) an emergency medical services vehicle to be > > > > 10 equipped with an epinephrine injector or similar device to treat > > > > 11 anaphylaxis; and > > > > 12 (2) emergency medical services personnel to complete > > > > 13 continuing education training in the administration of anaphylaxis > > > > 14 treatment. > > > > 15 SECTION 2. This Act takes effect immediately if it receives > > > > 16 a vote of two-thirds of all the members elected to each house, as > > > > 17 provided by Section 39, Article III, Texas Constitution. If this > > > > 18 Act does not receive the vote necessary for immediate effect, this > > > > 19 Act takes effect September 1, 2007. > > > > E. Bledsoe, DO, FACEP > > > > Midlothian, Texas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 5, 2007 Report Share Posted April 5, 2007 > > I'd like to throw out a thought for consideration regarding this. Does > requiring this specific piece of equipment for this specific use start us > toward a scope of practice? And worse yet, what about the people I run who SWEAR they're allergic to Epinephrine and Benadryl, because epi makes them jumpy and benadryl makes them sleepy? ::rolls eyes:: Mike :/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2007 Report Share Posted April 7, 2007 Nothing like a little Monty Python to brighten the day. Steve Lemming This e-mail is confidential and intended solely for the use of the individual (s) to whom it is addressed. Any views or opinions presented are solely those of the author and do not necessarily represent those of The City of Azle or its policies. If you have received this e-mail message in error, please phone Steve Lemming (817)444-7108. Please also destroy and delete the message from your computer. For more information on The City of Azle, visit our web site at: <http://azle.govoffice.com/ <http://azle.govoffice.com/> > RE: New Bill I know where this thread is heading: I never wanted to do this job in the first place! I... I wanted to be... A LUMBERJACK! (piano vamp) Leaping from tree to tree! As they float down the mighty rivers of British Columbia! With my best girl by my side! The Larch! The Pine! The Giant Redwood tree! The Sequoia! The Little Whopping Rule Tree! We'd sing! Sing! Sing! Oh, I'm a lumberjack, and I'm okay, I sleep all night and I work all day. CHORUS: He's a lumberjack, and he's okay, He sleeps all night and he works all day. I cut down trees, I eat my lunch, I go to the lava-try. On Wednesdays I go shoppin' And have buttered scones for tea. Mounties: He cuts down trees, he eats his lunch, He goes to the lava-try. On Wednesdays 'e goes shoppin' And has buttered scones for tea. CHORUS I cut down trees, I skip and jump, I like to press wild flowers. I put on women's clothing, And hang around in bars. Mounties: He cuts down trees, he skips and jumps, He likes to press wild flowers. He puts on women's clothing And hangs around.... In bars??????? CHORUS I chop down trees, I wear high heels, Suspendies and a bra. I wish I'd been a girlie Just like my dear papa. Mounties: He cuts down trees, he wears high heels Suspendies?? and a .... a Bra???? (spoken, raggedly) What's this? Wants to be a *girlie*? Oh, My! And I thought you were so rugged! Poofter! CHORUS All: He's a lumberjack, and he's okaaaaaaayyy..... (BONG) Quote Link to comment Share on other sites More sharing options...
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