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public access drugs

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  • 21-10-2015 10:53am
    #1
    volguy
    Registered Users Posts: 6 ✭


    hi guys so i was just wondering what people are making of the announcement of public acccess drugs for members of the public to use.
    i think that it is a good idea however what i am really wondering about is where this leaves EMT's, this is basically giving our entire set of meds to be given by members of the public who wont be acting with a CPG approved organisation. does this mean that practitioners wont need to be under CPG org to administer?
    ive read a few opinions that say EMT will get more meds but in reality what can be really given to EMT very few i think.
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    #2
    RiderOnTheStorm
    Registered Users Posts: 2,123 ✭✭✭RiderOnTheStorm


    It could be good, it could be bad .... it all depends on how its going to be rolled out & managed. Many a good idea has been started & ruined by admin / reg's / supervision / etc

    I am wondering what a "member of the public" is? Is this a trained First Aider (but not OFA, EFR, EMT, A, AP, doc, nurse, etc). Or is it the person who rings 999 and then the call-taker says they can give the pt drug x? If its a first aider, does that mean that all first aid courses are now going to change to add on a medications section? what about existing first aiders, will they have to retrain?


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    #3
    glenjamin
    Registered Users Posts: 2,484 ✭✭✭glenjamin


    I've spoken to a couple of people about it and it all depends on what exactly it's going to entail. It wouldn't really make much sense if a random member of the public can give more drugs than a trained EFR.


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    #4
    ectoraige
    Registered Users Posts: 2,100 ✭✭✭ectoraige


    I think it is a positive move. Members of the public aren't going to be going around carrying drugs bags randomly spraying GTN and Salbutomol at people. If they are in posession of the medication, and have cause to use it, the likelihood is they have themselves been prescribed it. This should give them at least some familiarity with it, at least in terms of doses. Of course there are issues surrounding contraindications, but the drugs listed are to prevent or delay the deterioration of life-threatening conditions. You would expect a public information campaign to help highlight these issues, and for the protocols for emergency call takers to be amended too.

    If you take the Pareto principle that 20% of effort provides 80% of the result, relaxing the restrictions on early intervention with this set of medications might be of greatest benefit to patient outcome. I don't
    really the understand the "where does this leave EMTs?" question though. They will still be there with the training, equipment and medication to help deal with a range of emergencies. Joe Public might have an inhaler, but that's not much use if the casualty is having a heart attack.
    glenjamin wrote:
    It wouldn't really make much sense if a random member of the public can give more drugs than a trained EFR.

    There's not really anything to prevent a member of the public from giving paracetemol to somebody else for a minor pain, but an EFR can't do this. You'd expect the "assist-only" restrictions on EFR meds would be dropped entirely.


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    #5
    glenjamin
    Registered Users Posts: 2,484 ✭✭✭glenjamin


    ectoraige wrote: »
    There's not really anything to prevent a member of the public from giving paracetemol to somebody else for a minor pain, but an EFR can't do this. You'd expect the "assist-only" restrictions on EFR meds would be dropped entirely.

    Paracetamol and Ibuprofen aside the new law will allow members of the public to give Naloxone and Glugacon if I'm not mistaking. Naloxone is straight forward enough asides from the dosage, but for a member of the public to be able to draw up a syringe, correctly locate an appropriate site, and administer an IM injection seems a bit crazy to me. And same goes with the likes of GTN and Entonox knowing all the possibles contraindications too. It'll be interesting to see how this progresses.


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    #6
    ectoraige
    Registered Users Posts: 2,100 ✭✭✭ectoraige


    glenjamin wrote: »
    Paracetamol and Ibuprofen aside the new law will allow members of the public to give Naloxone and Glugacon if I'm not mistaking. Naloxone is straight forward enough asides from the dosage, but for a member of the public to be able to draw up a syringe, correctly locate an appropriate site, and administer an IM injection seems a bit crazy to me. And same goes with the likes of GTN and Entonox knowing all the possibles contraindications too. It'll be interesting to see how this progresses.

    The members of the public who'll benefit most from naloxone have already mastered IV injections!

    Looking at the press release, then intent is for people to be trained, similar to AEDs - anybody is *allowed* use them, but they should be trained. Drugs/homeless charities for example would be interested in naxolone. PHECC will be given the job of developing courses to train users.

    Nobody is going to go to the expense of maintaining Entonox without the training, I'd expect GTN would be the biggest risk. There might be a few more people hitting the floor each year, but I guess the hope is there'll be more people coming into EDs still conscious.


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