Author Archives: SWORBHP

Is there a gestational age limit on administering oxytocin? For example, you have a patient that has miscarried in the first or second trimester and is hemorrhaging heavily after passing the fetus, would it be appropriate to treat with oxytocin?

In pediatric defibrillation, should I round-up, or down with available joule settings? For example, for a 10-month-old who weighs approximately 9.5kg, the initial suggested energy setting would be 19 Joules, followed by 38 Joules. Lifepack allows 15,20,30,50 Joules.

In regards to the cardiac ischemia medical directive, the latest indication is now suspected cardiac ischemia. If you have a pt presenting with all signs and symptoms of cardiac ischemia, have given ASA, established an IV, and have given NTG. If the pt's symptoms improve after administration of NTG should you continue with the directive to the full amount of doses provided the pt still meets the conditions?

Oxygen Therapy does not address patients with GI emergencies. If their Sats are within limits we cannot give O2 even though the patient may have internal bleeding and lost a lot of hemoglobin.

In regards to doing a Stroke Bypass for a palliative patient that is not end-stage, the directive clearly states “Terminally Ill or palliative care patient.” I think the blanket term ‘palliative care patient’ is misleading, as many people who are palliative are not close to dying. Are we to make our own decision about 'how palliative' a patient is and only apply this portion of the directive if they are truly end-stage? I think there should be something about their goals of care in the directive or something more clear so as to not rule out patients just because their palliative status (which could still allow them a good amount of time with quality of life). I think many medics may call for direction in this case, but there are others who would read the directive verbatim, thereby causing some patients to miss out on life-improving interventions. Is there any direction on this or am I on the right track with my thinking?

Should we be “piggy backing” dexamethson every time we give ventolin if the pt has a history of copd or asthma or 20 pack history.

What is considered the most appropriate means of transporting a pediatric patient? Is securing a child/infant in a car seat provided by parents to the stretcher better than securing them in the neonate or pedimate? We have the pull down jump seat for toddler booster seat, but would like to know what our BHPs think of the car seat on stretcher versus pedi/neonate.

Hello, what are the criteria for identifying hypothermia in a VSA patient? This affects our treatment under ALS PCS 5.1 whether we consider early transport after one analysis. The situation that brought up this discussion was a patient who had been on the floor indoors for a number of days, but still presented with a hypothermic body temperature. If the patient had been found VSA, how would we identify to treat them under the full medical cardiac arrest, or be considered for early transport?

In pts with poor peripheral perfusion (ie. sepsis) can we do a blood sugar reading on pts ear? Recently had call where pt was severely septic and we gave glucagon and then dextrose and pts blood sugar kept going down. ER doctor took blood sugar on pts ear where perfusion was better then peripherally and sugar levels were well above normal.

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