Author Archives: SWORBHP

Question: The DNR confirmation form states the paramedic will not initiate basic or advanced CPR such as, TCP being one of them. From what I understand, until that person suffers cardiac or respiratory arrest, they are fair game for treatment. So, if a patient is in a 3rd degree block at 20bpm and they have a DNR, we are pacing this patient?

Also, what do they mean on the DNR confirmation form about palliative care? They say we are to provide care to alleviate pain/discomfort such as - NTG, ASA, benzodiazepine, epi for anaphylaxis, o2, Morphine etc. Is this merely an FYI on how to treat a pre-code patient? Clearly the patient would have to be alive to administer these drugs. Again it is said that the DNR does not come into play unless the patient codes. Why is this on the form?

Question: This question is in regards to the TOR's and calling BHP. Some paramedic services lack having a spare cell phone while the primary cell phone for a truck is "out for service", missing etc. I have heard of some paramedics using their personal cell phones to call for the mandatory BHP patch for a pronouncement. I have spoken to Police and Crown Officials, and they have both stated that our personal phone can be submitted into evidence at an inquest or other matters, as this was the tool used to make that pronouncement (upon further investigation a paramedics credibility can be challenged as the court can see text messages, pictures, and phone calls placed on the personal phone). If our service fails to provide us with a cell phone for that shift for whatever reason, are we obligated to use our personal phone knowing it could be taking from us in an investigation for an unknown length of time? Would we document "no cell phone available" on the ACR?

Question: I have checked with a SWORBHP Educator and they did confirm that you cannot Medical TOR an OD but you can do Medical TOR on Drowning Hanging and Electrocution. There still seems to be doubt out in the field so I thought I would post so all could see answer

Question: If a DNR only comes into play once the patient has suffered respiratory or cardiac arrest, why do hospitals use DNR as an excuse to downgrade CTAS or justify putting certain patients as a code 7?

Question: When is the "new" treatment algorithm ALS/BLS for Medical Cardiac Arrest being posted?

Question: With respect to the Medical Arrest Protocol, are we still to alternate giving Epi and Amio/Lido on the 2 minute mark since each are to be given Q4 minute? Or can we give them at the same time? What is preferred?

Question: I’m not comfortable having to make critical decisions in the field, on calls that are few and far between, yet serious in nature. Is SWORBHP doing anything along with MOHLTC to advocate for regular training days to be a part of our regular schedule and duties? I'm all for continuing self-study, however, since so much of our job is practical application, don’t you think it is wise to give your paramedics practical practice? As an aside, in my opinion, insufficient funds is an unacceptable excuse not to. Fire and Police have always had ample training time, and we are just as important to public welfare. So could it be possible for all parties to come together and find the funds necessary? Thank you for creating this site and allowing me to put this issue forward.

Question: This is in regard to the Medical TOR protocol. If we've reached the mandatory patch point at three consecutive non-shockable analyses (and made the call to the BHP) and there is any sort of delay (meaning we've reached the fourth analysis), do we then transport? People are getting confused because some heard that they were to keep analyzing while they waited for the BHP to come on the line. That's not how I perceived it. Regardless of any delay at any time, the protocol states that we only analyze a total of four times (unless you are an ERU) followed by CPR for the duration of the call, correct? People hear different things, and I just want clarification so that we can all be on the same page. Thanks

Question: Why do we have a mandatory patch point for pediatric patients (> 2 but less than 12) with a blood sugar over 25 mmol/l and suspected to be in DKA for a fluid bolus but there is no patch point for adult patients.

Question: In regards to cardiac arrest secondary to drug overdose. A VSA in an instance where Cocaine and or Meth have been used in excess causing death. Would this fall under unusual circumstances and therefore be transported or would it follow a medical TOR and require a patch to base hospital?

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