What drugs can a CMT administer?

Discussion in 'Professionally Qualified, RAMC and QARANC' started by supertiger, Aug 31, 2013.

Welcome to the Army Rumour Service, ARRSE

The UK's largest and busiest UNofficial military website.

The heart of the site is the forum area, including:

  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:

    Adrenaline 1:1000

    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.

    Posted from the ARRSE Mobile app (iOS or Android)
  3. Thanks Ginge,

    really useful
  4. Civvie paramedics get a lot more than that! Google "JRCALC guidelines".
  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.
  6. Yes, we're all aware of that.
    Go back and read it again...
    Does it say ambulance paramedic or tech?
  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
    • Like Like x 1
  8. 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

    Posted from the ARRSE Mobile app (iOS or Android)
    • Like Like x 1
  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.
    • Like Like x 1

  10. 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. 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


    Posted from the ARRSE Mobile app (iOS or Android)
  12. Does injecting an incapacitated casualty with semen count?
    • Like Like x 1
  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?

    Posted from the ARRSE Mobile app (iOS or Android)
  14. 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.

    Posted from the ARRSE Mobile app (iOS or Android)
  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?