I witnessed a car accident today involving an elderly woman and another family that rear ended her. She walked herself over to the curb and then all of a sudden started crawling on the ground by the grass. There were no visible signs of injury- from the looks of it just whiplash but she was hyperventilating and crying. There was a nurse that stopped and helped her. With all this schooling in the medical field I feel like I should be able to do more than just ask her what medications she's on and if she had any other health conditions. :(

What other things do you think pharmacists can do in emergency situations like this?

Call 911

go mix some amiodarone for me while I intubate and start the iv....
all kidding aside, we have pharmd's respond to every code to help facilitate acquiring needed meds and on occassion doing a few calculations in selected patient populations( small kids, renal failure, etc) so there is a role for a pharmd on an in-hospital code team. if you want to be of more help outside the hospital take an advanced first aid, first responder or emt course and carry a good first aid kit in your car..

Don't feel to bad. For most people in the medical field, emergency training just isn't their bag and how you need to respond in an emergency is probably totally different then how you respond during your normal work.

I used to work in an ER and I found that non-ER nurses and doctors didn't have a clue what to do when a gunshot or car crash came in because the type of care that was needed was different then what they were trained to do. They were used to treating a stabalized person, not getting them stabalized. I responded to one crash while doing EMT training and a doctor tried to take over the situation. When asked if he ever had emergency experience he said no and was ignored from then on.

On the other hand, put an ER nurse on a floor, and he/she is going to be out of their element too.

Keep in mind that unless you know what you are doing, you can make the situation worse. The best thing to do is call 911, make sure they are breathing, and stop them from moving around. And don't feel bad if you can't do more.

controlling major bleeding with direct pressure is probably a good no brainer too......

That too.

keep up with the CPR certification :thumbup:

keep up with the CPR certification :thumbup:

Don't forget your ABC's

The the challenge comes when something happens in your pharmacy and you
are faced with taking care of your ailing customer or covering your butt.

Case in point; a woman came into my pharmacy with an impending allergic
reaction to shellfish. She was barely able to make it to the waiting area chairs
with assistance. Paramedics arrived before she really went south, but the thought crossed my mind that benadryl and an epi-pen were only 15 feet away. What would YOU have done had she stopped breathing? Keep counting and pouring? Do basic life support? Or jump over the counter and administer the epi-pen thus breaking the law?

Don't forget your ABC's

The the challenge comes when something happens in your pharmacy and you
are faced with taking care of your ailing customer or covering your butt.

Case in point; a woman came into my pharmacy with an impending allergic
reaction to shellfish. She was barely able to make it to the waiting area chairs
with assistance. Paramedics arrived before she really went south, but the thought crossed my mind that benadryl and an epi-pen were only 15 feet away. What would YOU have done had she stopped breathing? Keep counting and pouring? Do basic life support? Or jump over the counter and administer the epi-pen thus breaking the law?

I would use epi-pen. but i will be crapping my pants afterwards.

It's pretty hard to practice pharmacy without breaking the law at some point. What we are willing to break the law for says alot about who we are. Saving a life is a pretty good justification, in my book. Many pharmacists will do it for convenience's sake, like dispensing a birth control refill as a "fill and gone". The same law is being broken in this and the Epi-Pen scenario. It's sad how the more urgent of the two situations is the one in which fewer of us would be willing to dispense. If you are going to break the law, ideally it would be for a case in which you would be willing to publicly acknowledge and justify your actions.

Now, I'm not saying that administering the Epi-Pen without a prescription is the right thing to do in the situation. The right thing to do is to stop being scared of getting slapped on the wrists and think about how you can get the patient what they need. What you could do, while your technician dials 911, is to dial your local ED, state who you are, and ask to speak to the physician on duty. Seeing as how the patient will be shipped to them shortly anyway, they should give you a quick verbal over the phone.

Don Williams, the recently retired executive director of the Washington State Board of Pharmacy made an interesting point while lecturing in my pharmacy law class last week. He said when it comes to issues of law that are questionable, physicians routinely risk breaking the law and ask for forgiveness afterwards. Pharmacists incessantly call and ask permission of the board before doing things, even when doing so is clearly not in the best interests of the patient.

Now, I'm not saying that administering the Epi-Pen without a prescription is the right thing to do in the situation. The right thing to do is to stop being scared of getting slapped on the wrists and think about how you can get the patient what they need. What you could do, while your technician dials 911, is to dial your local ED, state who you are, and ask to speak to the physician on duty. Seeing as how the patient will be shipped to them shortly anyway, they should give you a quick verbal over the phone.

.

Been there done that. Unless you drink coffee with that ER doc don't waste
your time. The ER will not touch it without seeing him. I had a guy wander in with chest pain asking for nitroglycerin. He had never filled with me or it would have been a non issue. All I got from the ER was stonewalled.

The fellow left my store with ntg 0.4mg and a stern warning to follow up.

These scenarios happen frequently folks. A kid last night with an infection
in his tear duct came to me for help. His friends had sent him to the local feed store for livestock antibiotics. The warnings had frightened him and he came to me. I broke his heart and told him he needed to see a doctor. What would you have done? What would you have done if it was your best friend?

I had a rotation in the ER at a huge urban teaching hospital, and the pharmacist I followed around played doctor on several occasions. He would read EKGs, administer meds, etc. Really makes you wonder where to draw the line. He's obviously highly educated, but it's not what you would imagine a pharmacist doing.

As for the retail scenario, unless it's for an epipen or possibly an emergency puff of albuterol (even that's doubtful), I don't think I'll ever be gutsy enough to dispense anything without an Rx. This opens up lots of moral dilemmas, and that's one reason why I don't want to end up in retail...there are times when you know exactly what to do, only to have no authority to do it.

I agree with pretty much all of the posts so far. Emergency situations require not only training, but most importantly, experience. A pharmacist would really be out of his/her element responding to an accident or emergency situation that would occur, but that would go for anyone who is not a trained EMT or ER regular.

I think the best advice to give is that if you see an accident to treat it like any passerby or regular civilian should. Survey and assess the safety of the scene, ask if the victim is alright and if you can help them (if they are conscious, of course), and call 911 or ask someone to call 911 for you while you attend to the victim. This is something that everyone can do, whether they are a health professional or not. CPR training, knowing your ABC's, and having first aid training is also a plus.