Author Archives: SWORBHP

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

Posted on: November 25, 2020

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

From the Grey Zone presentation: Orders for treatment of a patient under your care (including on off-load delay) can only be taken from a BHP. A nurse cannot tell you to discontinue your Medical Directive unless transfer of care has taken place and you are no longer caring for or following your Medical Directive (or upon certain hospitals wherein shared-agreements exist such as STEMI-Bypass and care is shared responsibility and differs from the Medical Directive).

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2020 MCME Tip of the Week: Adult vs Pediatric Arrest Dosages

2020 MCME Tip of the Week: Adult vs Pediatric Arrest Dosages

Posted on: November 18th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Remember that the age cut-off for adult Epi and Antiarrhythmic medication in Cardiac Arrest is ≥12 years-old.

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I am an PCP IV certified paramedic, working with a non IV medic. If we have a hypoglycemic patient do I need to attend & consider D10/D50 or can my non IV partner treat the patient with Glucagon instead?” Same question for Gravol; do they need to get it IV or can non IV certified medic give it IM?

Good afternoon, my question is related to current ACS treatment guidelines. I have had several STEMI inter-facility transfers within the last month or so where attending physicians have initiated pain management with Fentanyl. Upon receiving patient handover from these physicians they often request that this treatment modality be continued throughout transfer. Due to the current AMHA research regarding increased mortality in ACS and STEMI patients who are treated with morphine, is there any move to eliminate this contraindication from the fentanyl protocol, or to remove morphine from the ACS treatment guidelines? If a Physician requests this treatment modality (fentanyl) are we able to patch around this contraindication for fentanyl or would this go against the spirit of the protocol patching around contraindications? If the Physician has initiated treatment with Fentanyl and we have exhausted our nitro protocol or it is contraindicated will we suffer repercussions for not initiating morphine treatment even when it was requested that we do not by the sending physician? Would we require a patch to NOT treat this patient with morphine? Why there is a heart rate range for nitro? what will happen if HR is below 60bpm and above 159bpm?

What exactly are the oxygen flow rates per mask? I was given a different answer (specifically for a NRB) as a working medic than my friend who is in school

Why there is a heart rate range for nitro? what will happen if HR is below 60bpm and above 159bpm?

I have a question regarding analgesic administration in regards to abdominal pain (ex diverticulitis, hernia). If the pt is complaining of abdominal pain stating "it feels just like my diverticulitis acting up" Or due to hernia pain with evidence of a protruding hernia, would it be appropriate to consider analgesic medication if no contraindications are met? Although you are not 100% certain of the underlying cause in the pre hospital setting

Has SWORBHP considered push dose epinephrine for ACP's? This treatment is being used for a variety of indications in many paramedic services throughout the globe and has literature supporting it. I know this was brought up in 2017 and one of the concerns was "anytime drawing up medications, there is a risk for medication error". There was a code epinephrine shortage in 2019/2020 and ACP's were reconstituting epinephrine from 1:1,000 to 1:10,000 during active cardiac arrest situations without complications.

2020 MCME Tip of the Week: Don’t Let Hospital Proximity Distract Your Resuscitation

2020 MCME Tip of the Week: Don’t Let Hospital Proximity Distract Your Resuscitation

Posted on: November 4th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Hospital Proximity should not typically play a role in decision to transport. Unless the patient has a potentially reversible cause of arrest that cannot be treated prehospitally, they should receive the best possible resuscitation in the field before consideration for transport. Don’t let hospital proximity distract you from your lifesaving resuscitation!

*Thanks to our PHCS Micheal Filiault for this awesome reminder

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2020 MCME Tip of the Week: Adult vs Pediatric Defibrillation Settings

2020 MCME Tip of the Week: Adult vs Pediatric Defibrillation Settings

Posted on: October 28th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Remember that the age cut-off for adult defibrillation settings is ≥ 8 years-old. Think Electricity – Thomas Edison – EIGHT.

*Thanks to our PHCS Tony Jaroszewicz for this memory aide

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