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Verified Military
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- Sep 28, 2010
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I'd love to have Ketamine available in the field. As it stands now PA paramedics are limited to opiates (MS/fentanyl/dilaudid) for pain management. Nitrous oxide is on the state list, but I don't know of a service that uses it. Trucks stock benzos, and some have etomidate specifically for airway management so sedation is possible. Benzocaine and tetracaine are also on the list, but obviously those aren't going to be used for significant pain.
The biggest issue I have with pain management in civilian EMS is that very few regions/services have a specific pain management protocol. Of those, even fewer allow appropriate dosing. When we call for orders and request a specific pain management regimen we often deal with a resident instead of an attending who is either afraid to give an order that will allow for substantial pain relief, or believes myths like you shouldn't administer pain meds to a pt w/abdominal pain prior to physician exam.
@Firemedic and I worked at a service where I was able to get a pain management policy instituted. It was essentially weight-based MS04 titrated to effect. We were the only service in several regions that could do it without asking for orders.
Pain management is given short thrift in prehospital care in this state.
Our medics aren't allowed to carry Ketamine as per the doctor we fall under. Hell she won't even allow them to have a fucking suture kit. It really sucks because as the bases close down we have less access to get that care for a soldier, case in point we had a soldier cut him self in the forearm with a gerber blood squirted pretty far. We were lucky that the PA in Farah wasn't due to fly out until the next day, he got some stitches that day but it was several days before we got back to Shindand.
Has anyone used, or are there discussions about using Ofirmev (acetaminophen) in the field?
The only reason why I made the comment that I did was that if they meet the Army's requirement to be able to utilize Ketamine then why don't they get the option to do so. My initial post was unclear and poorly written to convey my intent.