Author Archives: SWORBHP

My question is regarding STEMI bypass and hyperacute T Waves. We were called out for a 60's male patient experiencing chest pain after some physical exercise. It was quite apparent patient was likely having a cardiac event upon arrival and first examination. Patient had 8/10 midsternal pain (pressure) with radiation into shoulders. Patient was clammy, cool and diaphoretic. Patient had a weak radial pulse. After giving ASA 12 leads were obtained. Each showing hyperacute T waves in the chest lead V2 - V5. No elevation is noted, upon multiple 12 leads. No nitro was given as heart rate was below 60, but a lock was established. Patient was stable and wouldn't have any of the contraindication to STEMI bypass. We are a rural service and closest hospital is 7 minutes away and transport time to the cath lab would be roughly 25 minutes. Just curious how base hospital would like us to proceed on these calls in the future? a - go directly to closest hospital as there is no elevation yet and doesn't quite meet STEMI bypass b- call the closest cath lab and let the cardiologist decide c- first call base hospital to ask for further direction to see if cath lab should be called, then proceed from there. Thanks in advance

Can you TOR someone who is in PEA

This has been a question of mine recently that not many people have the answer for in my service. My question is; if we have given the pt any sort of medication or initiated an IV can the pt be offloaded to the waiting room or to a bed in the hallway? Thank you in advance!

Would it be appropriate to contact a BHP requesting titrated sedation for a compliant and non-combative patient experiencing agitation with inability to remain still preventing proper assessment due to stimulant use? I find these patients are occasionally even difficult to transport due to writhing on the stretcher let alone perform an appropriate assessment.

Is it considered an Inferior STEMI if only II, aVF are presenting with ST elevation as they are technically not contiguous?

TOTW: Symptomatic Bradycardia

TOTW: Symptomatic Bradycardia
Posted on: May 12th, 2021

TOTW: Symptomatic-Bradycardia

Please remember when treating a patient with Symptomatic Bradycardia:

The patient is required to be:
1.BRADYCARDIC (HR < 50)
2. HEMODYNAMICALLY Unstable (refers specifically to SBP <90)
3. ≥18 years

Please remember the 12 LEAD (as early as possible)!

Mandatory Provincial Patch Point = Required for the use of Transcutaneous Pacing and/or Dopamine!

Treatment Pearls:
Dopamine = Starts at 5 mcg/kg/min titrate SBP to ≥ 90 to < 110
Pacing = start at 80 beats/min and then increase mA until capture (mechanical/electrical) then go 10 mA above to lock it in.

*See the OBHG Companion Document (v4.8.1) for further pearls and considerations regarding this Medical Directive

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On our ACRS, when we have rhythm interpretation and if we are unsure of what the rhythm is, is it okay to leave it blank?

Why is nasotracheal intubation reserved for patients above the age of 8?

Do we still suction neonates immediately after birth?

If our patient has been accepted for Bypass under STEMI protocol, and pt goes VSA on route, in the event of a ROSC do we continue to proceed to Cath lab or do we now reroute towards closest ED?

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