ABSTRACT: Emergency medical training programs (EMT-Basic, -Intermediate, -Paramedic and Nursing or Physician programs) are frequently unable to spend an adequate amount of time discussing patient-administered prescription medications ("Home Meds"), and how important their consideration is to caring for individuals experiencing ANY emergency crisis.

At this writing, there are well over 3000 home meds in existence. (This number does NOT include non-prescription - OTC - medications or herbal supplements!)

Many medications may alter the patient's response to acute illness or injury (altering the signs and symptoms they demonstrate), or may alter their responses to emergency-administered medications (EMS meds). Additionally, patients using many medications may have "hidden" patient care needs and altered assessment considerations. Without an understanding of how Home Meds may cause odd or altered signs and symptoms, EMS-med interactions and hidden problems, emergency care providers are unprepared for unusual patient presentations or unexpected responses to standard prehospital treatments.

This presentation is prefaced by information regarding the most effective techniques of
Patient Medication Questioning - something VITAL to the recognition and consideration of patient medications when assessing and treating all patients!

Depending upon presentation length (1-hour, 1.5-hour, 2- 3- or 4-hours), this presentation will address the actions, indications, common side effects, potentially altered assessment considerations, and potentially altered response to EMS-administered meds, for some (or all) of the following medication types:

• ACETAMINOPHEN
• AGENTS that PROLONG THE Q-T SEGMENT
• ALPHA BLOCKERS
• ANTICOAGULANTS & ANTIPLATELET agents
• ANTIPSYCHOTICS [and Extrapyramidal Syndrome (EPS)
  - also known as "Dystonic Reactions"]
• BARBITURATES
• BENZODIAZEPINES (and flumazenil)
• BETA BLOCKERS
• CALCIUM CHANNEL BLOCKERS
• CANCER medications
• CYCLIC agents (tricyclic and tetracyclic)
• DIURETICS
• LIDOCAINE ANALOGS & Agents that
  INCREASE LIDOCAINE SENSITIVITY
• MAO INHIBITORS
• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
• OPIATES & NARCOTICS (and naloxone)
• PARASYMPATHOMIMETIC agents
• SALICYLATES
• XANTHINES (theophyllines)

LEARNING OBJECTIVES: After attending this presentation, participants will:

1. enjoy an improved ability to obtain a complete list of the patient's medications.
   
2. recognize the need to become familiar with various medication groups,
   rather than attempting to memorize multiple drug names.
   
3. recognize that patient-administered medications ("Home Meds")
   may produce altered reactions to emergency-administered medications ("EMS meds"),
   or may promote unusual assessment and management considerations.
   
4. understand the need to obtain, and USE, a pocket-sized home meds reference book -
   to access important medical history information, to be forewarned of potential side effects,
   or to anticipate altered reactions to EMS meds.
   
5. recognize situations requiring unusual evaluation, management,
   or the need to consider altering standard EMS protocols.
   
6. be reminded of the absolute contraindication for altering protocols or care standards
   without first obtaining orders from the physician-advisor.

Home Meds presentations can consist of 1-hour, 1.5-hour, 2- 3- or 4-hour programs as requested.
Be advised that Charly documents what Subjects she presents - Where and When. That way, when asked to do a "return engagement" at any location, her Home Meds "reprise" presentation will address entirely new and different medication subjects!

1. INTRODUCTION:
   
   • Why is on-scene (rapidly accessed) knowledge about Home Meds important?
   • What does an emergency care provider need to know about Home Meds?
   • What resources are available on-scene (or rapidly accessed), and how do you use them?

2. PATIENT MEDICATION INTERVIEW TECHNIQUES: A discussion of the most common mistakes made by ALL care providers, when questioning patients about medications. Simple, effective solutions to these medication-question mistakes are identified.

3. SUBJECTS: The medication subjects for any presentation will be selected based upon the presentation's time length, previously covered drug subjects (in the event of a "return engagement"), and any special requests made by the Host. Coverage will include discussion of each medication's:
   
   • Actions and Physiologic Effects
   • Indications for Prescription (Patient Medical History Clues)
   • Common Side Effects (Especially Adverse Ones)\
   • Potentials for altered signs and symptoms presented by patients ON the medication.
   • Potentially Altered Responses to EMS Medications
     Caused by the Patient-Administered Medication.
   • Specific and vital "clues" provided by the patient's medication.

4. GENERAL TREATMENT CONSIDERATIONS: Considerations common to all emergencies involving patients who are taking prescription medications, or OTC (over-the-counter) drugs.

5. SUMMARY

Email Charly at: c-d-miller@neb.rr.com
Those are hyphens/dashes between the "c" and "d" and "miller"