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What sort of things you would like the Paramedics to know/be aware of?

I have a general question for you all. I am writing an article for my ambulance service colleague to raise awareness of IBD, and its potential complications that may present to the ambulance service, and I was wondering what sort of things you would like them to know/be aware of? I know calling for an ambulance is absolutely the last thing any of us would do, but if you needed to, what would you find helpful? This is what I have so far:
What is IBD (and a bit more info on CD and UC) and why it is different to IBS
who gets it
symptoms (GI, extraGI and mental health)
common treatments (medical - including drugs, complementary and diet related, and surgical),
potential emergencies (such as severe dehydration, issues surrounding steroids, blockage, perforation, mental health issues)
anything else?

I know it is really cheeky to ask, but know you guys are a wealth of information and experiences. Thank you in advance!
Thanks Madmouse.
I think they need to know that people may be suffering greatly but still look "ok". For example, not all people with IBD are skinny, and some who are not can still be severely malnourished. Malnourishment in general should be on your list--as they may have trouble thinking well and may not give an accurate history or they may minimize the severity of their situation.
happy - thanks, had the look OK down under pain as 'you don't look in pain' is one of my main bugbears , but have also experienced 'but she looks well' (which was followed by an amusing argument from the gi team that included the phrase 'dead people often look well, and they are not') (from drs in general), but will def add that in, thanks :)
They should be starting fluids in the ambo, not waiting 5 hours later once your finally seen. Zofran is a must IV.


I think it's also extremely important to know that IBD is a very individualized disease -- just because they know all potential symptoms doesn't mean that they're present for everyone. Some people are even asymptomatic, but still have dangerous inflammation that no one can visibly see.

I also think extraintestinal manifestations are really important to understand and recognize, too. Otherwise I think they might be hasty to treat that without realizing it has an underlying cause.
Hi guys, thanks for your responses so far, really helpful and reassuring that I am on the right lines!

I am looking at UK based paramedic practice, so what can (or not) be done is very much dependent on skill base, and available guidelines/drugs.

I just want to comment on your suggestions so you know how it fits in with UK practice and how I have (or aim to) cover them, also, to make sure I am thinking the same things as you are - if I have misunderstood or missed anything please let me know!

Fluids: unless clinical unwell with dehydration, it is not appropriate to start fluids prehospitally for a couple of reasons. The range of fluids available is limited and therefore not necessarily appropriate - electrolyte deficiencies which influence fluid decisions cannot be tested for. Also fluid resuscitation needs to be done in a controlled manner, over time, and carefully monitored, which is why in the UK it is good practice in hospital to use a pump to ensure best delivery - these are not available prehospitally as common practice. Having said that, it is a point I have made in terms of 'consider the need for fluids as these patients are at high risk of being severely dehydrated' - or words to that effect.

Ondansetron (Zofran) - this a a new drug for UK paramedics, and has replaced/is replacing other antiemetics, which were used previously - I will definitely make sure it is highlighted as a consideration.

asymptomatic/'looks well' - an area I plan to include as part of pain management and being wary of dismissing patients who may 'appear well'

when giving an overview of IBD, I aim to explain (like pretty much every condition) that it is not a one size fits all - thankfully an integral part of our education, so hopefully will be easily accepted

ExtraGI stuff - yes, an important part of the condition, I hope to raise awareness of a range of symptoms/problems as well as highlighting how an extraGI symptom is still clinically important (so for example, worsening joint pain may be an indicator of increased inflammation, but there may be no extra GI symptoms)

drugs - a reminder of drugs to avoid in such patients (such as NSAIDs) will be helpful, although in an emergency there very few drugs that would be withheld - but consideration of additional drugs (such as a stat dose of steroids in patients on long-term steroids who are acutely unwell/injured) is something I will cover.

I am really really grateful for your help with this - for me (as a patient and as a clinician) I think its important that such articles are relevant for all. I just need to make sure I keep it within the word count! :)