Author Archives: SWORBHP

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?

Question: I was talking to an ACP who informed me a standard of care I had not heard of. He told me that all Obstetrical patients who have a syncopal episode should have a 12 lead done. He also said that 12 lead can be done pretty much on anyone. I was under the impression that 12 leads were to be done on patient's with chest pain. or symptoms consistent with ischemia. From what he was saying I was getting the impression that we should be doing 12 leads on most people to rule out any underlying cardiac conditions.

Question: For a patient with fluid building up in the lungs (recently having the same issue and having to have fluid drained via chest tube) due to a complication of CA, what is the best course of action? It wouldn't seem that a bronchodilator wouldn’t be effective and since the fluid is of non-cardiogenic nature would nitro work?

Question: In regard to the new Acute Pulmonary Edema protocol and the confusion surrounding it. Are we really giving 0.6 to 0.8 mg of Nitroglycerin SL to a patient with no IV and an Hx of use and a SBP of >140 mmHg?

Question: With the assumption that the Cardiac Arrest Medical Directive applies to patients > 30 days, and the Neonate Resuscitate Medical Directive applies to patients < 30 days, can we administer Epi to Anaphylaxis VSA patients under the age of 30 days? (We realize this is a VERY rare what-if).

Question: In performing your ABCs on unconscious patients, the BLS has never clarified whether, after checking the airway you should, insert an airway then go to breathing OR go to breathing, insert 2 breaths, then insert an airway. Can you finally put an end to this debate?

Question: If a patient is between ages 8-12 and is VSA, are we still using the lowest Joule setting?

Question: If you get a ROSC on scene, after one analyze, patient rearrests enroute, can we pull over and finish the protocol? One analyze or three?

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