PDA

View Full Version : Can't live without Meds


Cass100199
11-25-2008, 20:30
I have a question for those who have been the sole medical provider for your team. I just recently went through the MTT Medical Pre-deployment Course at Fort Sam and we spent a lot of time on pharmacology. Being a regular ol' medic, my drug exposure has been mostly NSAID's, etc.

If I do end out on my own, what are the "can't live without" drugs, including antibiotics, that I want to make sure I snag.

I personally have no intention of giving anything I don't know how to use, so I do have two books on meds and antibiotics to refer to to make sure I'm giving the right dosage, etc.

Surgicalcric
11-25-2008, 21:03
And are we talking about trauma, sickcall, MEDCAP, etc?? Have you talked to your Bn SGN/PA about what parameters you have to work within and asked them for guidance? Have you talked to the senior medic in your company or BN? Did you ask for guidance from the instructors in your MTT course? If you didnt ask those I previously listed then why are you asking here? If you did ask, what were their answers and again why are you asking us?

Dont misunderstand me. I am more than happy to help you (providing you didnt find help from those listed above) but understand our scope/skillset is somewhat different than yours and with that our list will be as well. However, I want to be sure you arent asking someone else to do your work for you...


Crip

Cass100199
11-25-2008, 21:22
Gotcha. Mostly I'm concerned about Primary Care. As of right now, I have no idea who my PA is going to be or where they will be located around me. From what I understand, I could end up on Taji (where this question is moot), or out in the middle of nowhere with the closest Provider a bit of a trip. Short answer, I have no parameters or protocols to work within at the moment.

I'm fine when it comes to NSAID's and pain managment. My biggest concerns are Derm and antibiotics. For General Sick Call stuff, I'm pretty confident in what to give and why.

The MTT Course itself was a pretty broad exposure, to be honest. The derm lecture was great, but is really far outside what i'm used to dealing with. As for the antibiotics, we had so many thrown at us, and I could only absorb so much.

edit: Yes, I did ask, and got several answers, from several PA's and Docs. What I'm looking for is the on the ground answer from those who have been the sole medical personnel for thier team, in a remote area, where higher echelon care is not immediately available. At the moment, the best answer I got was to use the TC3 guidelines for antibiotic use, but to be honest they list several kinds of antibiotics and I'm looking to strip that down to a few I can get to learn well. The reasoning being that I'm not sure what my supply line will be like, and if I can only get my hands on a few things, I want to make sure I'm grabbing the right stuff, and that I'm not grabbing some powerful broad spectrum stuff that will haunt their later healthcare.

I understand the scope thing and have no illusions about my skill set compared to yours. That's why I come to the best for advice.

Surgicalcric
11-25-2008, 21:42
Dont feel bad about the derm issues. I believe with the exception of Dermatologists most all other HCP's struggle with it from time to time.

You need to wait until you have talked with your PA/SGN and have guidance before formulating a personal formulary.


Crip

Eagle5US
11-25-2008, 23:51
Unless you have been through the ADSOCM course you will not be authorized any antibiotics anyway. Exposure for the MiTT medic training does not qualify you to dispense prescription medications.
A similar situation is people attending, and receiving a card for, ACLS / PALS / ATLS. By attending the course it grants you exposure to the material and a general understanding of how that material is utilized. The course and the card provide absolutely ZERO authorization to perform those procedures or utilize those medications unless you are you are credentialed at that level of performance.

There will be a medical provider assigned to you and your area. Our area had 17 MiTT medics controlled by our BDE SGN, he subsequently assigned two or three specifically to each of the providers within the Bn. We were responsible for reviewing the SF600's they would produce and act as their "medical control" via phone if they had questions on a patient, and see their folks when they brought them to the FOB. Any patient that requires more than sick call type care, you will be calling that provider on the phone or taking the patient to the nearest FOB for treatment.

Do not confuse "exposure" to pharmacology with the ability to write for prescription medications. Antibiotics are outside your scope of practice. Our MiTT medics had to pass a written test before signing for their morphine - and it was accounted for on a monthly basis.

Other than sick call meds...you are limited. So don't worry about things that will cloud your brain and potentially get you in trouble.

Eagle

Cass100199
11-26-2008, 07:31
Do not confuse "exposure" to pharmacology with the ability to write for prescription medications. Antibiotics are outside your scope of practice. Our MiTT medics had to pass a written test before signing for their morphine - and it was accounted for on a monthly basis.

Other than sick call meds...you are limited. So don't worry about things that will cloud your brain and potentially get you in trouble.

Eagle

No confusion at all on my part. The less meds I have to give, the happier I am. I've based my question on what I was being taught at the MTT Course.

Personally, I hope that having access, like you mentioned above, is what I have. I am not comfortable with attempting to make any kind of diagnosis, but once again, the MTT Course is insinuating that we could be in a positioon where we have to diagnose. I'm a damn good Medic, but I also know my limitations.

cdwmedic03
11-26-2008, 22:22
Can the guy get an answer to his question, or are we just gonna tell him what he can't do? If you didn't need to know, they wouldn't have put it in the training POI right? Here goes my .02



Edit by Eagle
WE doesn't include YOU.

What he is and is not authorized to do will be dictated by his medical control as previously mentioned. They will then determine what meds he will have access to and how they will be administered.
What you have been authorized to provide from your medical control is irrelevant.

Eagle

Eagle5US
11-26-2008, 22:50
Can the guy get an answer to his question, or are we just gonna tell him what he can't do? edited by Eagle - you are out of your lane
Hope this helped.

Not only are you wrong, but you are out of line.
As a 23y/o 68W you are in your infancy as far as medical training goes.
Do not post this type of response again.
You have nothing to contribute to this thread other than your eyes to read and your brain to learn.
This will not happen again.

Eagle

Eagle5US
11-26-2008, 23:05
No confusion at all on my part......... I've based my question on what I was being taught at the MTT Course.


Refer to my statement regarding what is taught in ACLS / PALS / and ATLS in post number 5.

Your ability to discern safe illness from unsafe illness, and proceed with a differential diagnosis to provide to your medical control, will go a long way in extending your ability to keep your MiTT team members healthy and missoin ready.

Eagle

Cass100199
11-27-2008, 08:02
SC, you are absolutely right. I'm concerned about something when I haven't even been given a specific protocol yet. I guess I like to plan too far ahead sometimes. Thank you.

Refer to my statement regarding what is taught in ACLS / PALS / and ATLS in post number 5.

I'm not sure you're getting what I'm asking, or that your familiar with what the MTT Predeployment and the MTT training at Fort Riley is covering. Either way, I appreciate your input. Thank you.

Surgicalcric
11-27-2008, 08:38
Cass:

He got what you were asking.

He made an analogy between people attending the courses noted below and your MiTT medic course. Your PA/SGN has to sign off for you to utilize what you have learned. Based on their guidance you may be able to use all that you learned or just some of it. Until you have said guidance I would focus on brushing up on any area you may be lacking in.

Crip

Cass100199
11-27-2008, 10:08
Cass:

I would focus on brushing up on any area you may be lacking in.

Crip

And that's why I'm here; always seek out the subject matter experts. Thank you gentleman.

Eagle5US
11-27-2008, 10:17
I'm not sure you're getting what I'm asking, or that your familiar with what the MTT Predeployment and the MTT training at Fort Riley is covering. Either way, I appreciate your input. Thank you.
I know exactly what you are asking for. You are asking for what all of my MiTT, and our BDE MiTT, medics asked for. The problem here is that you are not listening to the answer that is being provided because it is not what you want to hear.

At your level of training, you will not be able to make diagnostic decisions without someone else signing off on your ability to do so. Surgicalcric provided you with a very blunt and straightforward answer that I agree with completely.
You need to understand your limitations are dictated to you by your medical control. The MiTT train-up is nice exposure but it provides your no credentials.

Me going to space camp does not make me an astronaut. It gives me exposure so I know what the astronauts are talking about and I can kind of speak intelligently to them when I am describing a problem with my spacecraft. When they tell me what to do to fix it, I will know what THEY are talking about.

I am very familiar with what the MiTT trainup and MiTT deployment training entails. I am telling you, with the benefit of experience running multiple iterations of MiTT medics in country, that there have been a significant number of MiTT medics who have gotten themselves, and their teams / team mates in hot water by overstepping their boundaries on the premise that "I'm the medic and I'm on my own".

We are trying to prevent you from being one of those people by giving you the correct answer. If you choose not to listen to it, that is on you.

Thread Closed

Eagle