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Mass. approves IV Tylenol during hospital transport

The decision, which came down Friday, allows paramedics across the state to administer acetaminophen, Motrin and an IV option of Toradol

By Curt Brown
The Standard-Times

BOSTON — State health officials approved the use of IV Tylenol during hospital transports and within a few months the alternative pain medication could be on ambulances in Acushnet, Dartmouth, Fairhaven and New Bedford, local officials said.

The decision, which came down Friday, allows paramedics across the state to administer three non-opioid pain medications acetaminophen (IV Tylenol), Motrin and an IV option of Toradol, an anti-inflammatory, while a patient is being transported to the hospital, said Acushnet Fire Chief Kevin Gallagher. Previously, the only options to relieve pain were ice and fentanyl.

The decision on which medication is administered is made by the paramedic in consultation with the patient, he said.

The state Medical Services Committee unanimously approved the addition of IV Tylenol to Protocol 2.13 Pain and Nausea Management Adult and Pediatric in late April, after listening to a 7-minute presentation by Dr. Matthew Bivens, an emergency room physician at St. Luke’s Hospital and the hospital’s EMS director. The state Medical Services Committee stamped its approval as “an emergency change,” Gallagher said.

The hope was to close off one avenue — fetanyl — that could possibly lead to drug addicition. Friday’s action by DPH gives local EMS operations three more alternatives to ice and fetanyl. “Having more tools in the took box is always a good thing,” Gallagher said.

The approval by the state Department of Public Health follows a social media campaign conducted on Acushnet Fire Department and EMS’s Facebook page to speed up the approval process. The campaign, which only started Monday, has been seen by a total of over 70,000 people and has been shared a total of over 500 times.

The campaign was started when Gallagher and other Acushnet paramedics, after waiting months, did not see any movement at the state level and were only told “expect something soon” when they inquired about its status.

“I am elated, simply elated,” Gallagher said Friday of the state’s approval. “I get it. I understand that it takes the state a long time to change things, but time is a wasting. To get that out sooner rather than later means we can start using it right away and everyone wins.”

The change, which is not a requirement for local emergency medical services, goes into effect statewide the end of this month, according to an email from spokeswoman for Gov. Charlie Baker that Gallagher shared.

All it needs is the approval of the local EMS director (Dr. Bivens), and then for paramedics to be trained and it will be stocked on ambulances in Acushnet, Dartmouth, Fairhaven and New Bedford. Bivens is the director of emergency medical services in the four communities.

Bivens said he was delighted by the news. “It’s very exciting that the state’s Office of Emergency Medical Services and the Department of Public Health have approved these non-narcotic alternatives for pain management,” he said in an email. “A large number of doctors and paramedics have been working for years now to broaden the pain management options on ambulances. It makes perfect sense in the middle of an opioid epidemic for EMS to have non-opioid treatment options.”

Bivens also praised those who helped make it happen, citing Gallagher; Mark Miller, new head of the state’s Office of Emergency Medical Services; and the state EMS medical director, Dr. Jon Burstein.

“EMS is on the front lines of the opioid epidemic,” Bivens said. “Paramedics see people who have accidentally overdosed on narcotics and save their lives literally every day in Massachusetts ... I know paramedics are going to be relieved to have both narcotic and non-narcotic options to treat pain.”

Asked if IV Tylenol could expected to be on ambulances in Acushnet early next year, Gallagher said, “sooner. We’re chomping at the bit.”

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