What drugs can a CMT administer?

#1
Hi all,

I know morphine can be administered, along with copious amounts of brufen and double doses of screech, but what other drugs are Techs authorised to administer, or is that it? would anything else have to be given when casualty is moved rearwards? Possible wah?
 
#2
Has the same drug rule book as a civvie ambulance tech:

Oxygen
Adrenaline 1:1000
Salbutamol
Paracetamol
Ibuprofen
Glucagon
Aspirin
GTN
Hydrocortisone
Naloxone

AutoJet IM Morphine in trauma only

250mls IV fluid bolus' to maintain radial pulses/level of consciousness (if signed off for it I believe)

And a few more.
Plus whatever an MO is willing to risk his insurance on (sign you off on).

TO ADD-
In cas-evac, unless they are having an asthma attack or a heart attack or a boobood elbow as well as their IED/GSW. It's pretty much morphine where indicated, oxygen when available, and then hand over to the big boys.


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#5
Think a CMT prescribed me antibiotics when I was in around late 90s.

Although when I was an RMA in early 2000s, CMT/medics weren't allowed to prescribe anymore (think this was just a BFG med centre thing), but just as I left that trade, I remember it was about to change and prescription rights were going to be given back, and one of the nurses looked through the book listing whatRMA/CMTs would be able to prescribe and said that it was more than a nurse could prescribe.
 
#7
When I was a lad, waiting for Ivan, we had CRT's that, depending on your quals, acted as a PGD in a way.
Clinical Governance came along and legislation changed/brought in means alot of stuff in the bag is out of bounds but what goes on tour etc.... And it depends if you're green or black
 
#8
Civvie paramedics get a lot more than that! Google "JRCALC guidelines".
Yes, we're all aware of that.
Go back and read it again...
Does it say ambulance paramedic or tech?
As stated. I said civvie tech. A CMT1 is not equivalent to a civilian Paramedic. Unless the AMS has sent on onto a civve paramedic course... Which it has only rarely started doing.

The only time it changes is if you are a TA CMT, qualified as a civvie Paramedic, then you work to your civvie registration. Which allows you to do more. As a reg CMT, you are bound by army rules.

Cheers mandownmedic.

And though people are mentioning antibiotics and all that jazz, OP was talking about combat casualty care, and at no point during care user fire or evac will anyone prior role 2+ be giving antibiotics.

In the CMT guidelines, there are standard primary care guidelines that indicate some
antibiotics, ie UTI etc. Though non applicable on current point of context


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#9
Thanks all,

I am familiar with JRCALC, I was originally just after some information as to what a CMT would carry whilst on exercise and operations with regard to medicinal drugs. Would there be a standard kit issued to each CMT or are there kits that you sign out as and when? The reason i am asking is that i am joining a Reserve med regt, and am trying to garner as much info as possible without phoning the recruiting team every time i have a query.
 
#10
When I was a lad, waiting for Ivan, we had CRT's that, depending on your quals, acted as a PGD in a way.
Clinical Governance came along and legislation changed/brought in means alot of stuff in the bag is out of bounds but what goes on tour etc.... And it depends if you're green or black

Aaaah. Yes. Casualty Treatment Regimes (CTRs). I still have a copy.
They were good. Up to a point.
Medicine and scope of practice/PGDs have probably have made them redundant.
In the field ambulance we carried heaps of primary health care drugs but very little trauma kit if I recall.

Everything is single use only nowadays.
 
#11
Thanks all,

I am familiar with JRCALC, I was originally just after some information as to what a CMT would carry whilst on exercise and operations with regard to medicinal drugs. Would there be a standard kit issued to each CMT or are there kits that you sign out as and when? The reason i am asking is that i am joining a Reserve med regt, and am trying to garner as much info as possible without phoning the recruiting team every time i have a query.
There are different modules per role. So there is basically a CMT1 man portable med set of kit that you would get on deployment. Exact specs vary on role and skill (eg there is a paramedic med module).

However, you will only be issued these on deployment. Due to cost and use by dates, there is pretty much nothing issued to a medic until you are doing it for real. CMT courses provide all necessary training equipment during the in house phases, but you will not be issued any medical kit until onto full scale exercise or deployment as a BATLS and BARTS CMT1.

Medical units will have some modules for sign out, though they will not usually contain a full range. Again, due to costing, skill and use by date. They are more realistically training tools. And will not be individual issue.

The UK has an emergency service that pretty much nullifies the need for fully equipped RAMC personnel other than minimum BCD kit on ranges etc.

It all changes on tour; in your CMT1(reg) course, which you will do before any deployment. (Regardless of if you are a CMT1v)

You'll then be given theatre, kit and role specific training. As well as BATLS and BARTS, which is all your advanced trauma skill. You won't be giving any medication until this, not unless things change.

Any questions, feel free to pm

Ginge


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DieHard

LE
Book Reviewer
#13
If a vien can be found can a cmt administer iv morphine or does it have to be im? Obviously the iv works a hell of a lot quicker.
Do cmt carry anti emetics, ie ondonsotron, cyclizine, to counter the nausea and vomiting that morphine can cause?
Last question, what is the stat doseage of an autojet pen 10mg or the max dose of 20mg?


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#14
If a vien can be found can a cmt administer iv morphine or does it have to be im? Obviously the iv works a hell of a lot quicker.
Do cmt carry anti emetics, ie ondonsotron, cyclizine, to counter the nausea and vomiting that morphine can cause?
Last question, what is the stat doseage of an autojet pen 10mg or the max dose of 20mg?


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Dosages do not equate to the same strength when using different routes.
10mg IM would not provide the same pain killing capabilities as 10mg IV. Though the same dose, the absorption rate is different.

Morphine is only provided in IM autoinjectors, as to avoid IV administration. Which is 10mg. Which can be given up to twice, 30 mins apart.

Complications of IV overdose are reduced cardiac output, central nervous system depression, respiratory depression or even respiratory arrest. 10mg of IV morphine in trauma can be a dangerous amount

MERT (RAF) Paramedics and Civvie Paramedics are allowed to give IV morphine (US give ketamine), but under strict rules, but wouldn't have the IV drug if working as a CMT.

As far as I am aware, 10mg metoclopramide is the current indicated anti sickness, although changes towards ondansetron are occurring.


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#15
First, to give an answer to the OP, it is all about accountability.
Can you justify your actions if it goes pete tong?

The auto jet is 10mg IM, not really a pain killer, more of a pain tickler.

If there is a clinical indication to administer a drug, and you are aware of the contra indications, and it is in the best interests of the patient, can you justify not giving it?

The CMT is the most under utilised resource in the army in my opinion. We really could drop a gear and get CMTs on a par with paramedics but change is slow and the question contentious.

So I'll punt the question back to the forum,
If there is a clinical need to administer a drug, and you are aware of the contra indications, can you justify not administering it?
 
#16
Do you have the capability of managing any changes in your patients condition as a result of administering the drug.

I'm not sure I agree with the ability to bring CMTs up to par with paramedics. In trauma, they are the best you will find. But is it worthwhile adding the rest of a paramedic syllabus to their work load?
Never in a CMT career will they witness the same categories of calls as a civvie paramedic. The amount of medical jobs; cancer, dementia, geriatric medicine, paediatric, chronic respiratory disorders.

Great to know, but are they necessary for a combat medic?


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#17
Do you have the capability of managing any changes in your patients condition as a result of administering the drug.

I'm not sure I agree with the ability to bring CMTs up to par with paramedics. In trauma, they are the best you will find. But is it worthwhile adding the rest of a paramedic syllabus to their work load?
Never in a CMT career will they witness the same categories of calls as a civvie paramedic. The amount of medical jobs; cancer, dementia, geriatric medicine, paediatric, chronic respiratory disorders.

Great to know, but are they necessary for a combat medic?


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Squaddies get all of the above and so do their families.

Easy to train, emergency care practitioner, not necessary paralytic, but trained by, and rotated through, the NHS.

Or call them stretcher barer or canvass mech and leave it as it is.

It depends on the depth and breadth of knowledge you feel is adequate for caring for people.

I say keep investing in the blokes, but I appreciate that some old fashioned types might call me a heretic for believing that high quality care and investing in our greatest resource is a priority.
 
#18
That we can agree on... I believe they should do more, NHS rotation is without a doubt the way it should be done. You will experience more in 6 months with an ambulance service/A&E than you will a career in a unit med centre.

But it isn't feasible to bring everyone up to paramedic.

What the AMS is doing, is trying to bring CMT1 into correlation with Ambulance Technician, and introducing a CMT1enhanced for those qualified as paramedics. Which all sounds like hugs and kisses from here.


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C

count_duckula

Guest
#19
Medics and nurses get fed back into the NHS system, there are loads at QA Cosham and in Brum etc and there is no reason why this shouldn't happen to CMTs as well.
 
#20
Here lies the issue; there is no civilian NHS pid that a CMT fits in. So they don't just slot in

They aren't nurses, HCAs, paramedics or techs.


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