The REMAC protocol for poisonings and drug overdoses is a new addition for this current iteration, and it serves mainly as a reference for various reminders surrounding potentially dangerous exposures. Note that for patients who are altered, this protocol still refers out to the AMS protocol, so if the exposure in question is something like an opiate, instructions for naloxone and subsequent care are found in that section.
The poisoning/drug overdose protocol provides more general advice for managing with exposures that may otherwise be undifferentiated. Precautions are abound, reminding providers to avoid inducing vomiting or neutralizing ingested substances, ensure scene safety for inhaled or absorbed substances, and how to manage envenomations (remove stinger, immobilize the extremity, don’t capture the animal, etc.). Keep in mind that, after making sure the scene is safe for both patient and providers, the bottom line is the primary survey. So when in doubt, remember your ABCs (and that the snakebite center is at Jacobi).
More stuff next week! Until then, www.nycremsco.org and the protocol binder.
Dave