Author Archives: SWORBHP

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?

Question: Recently, after transporting a stroke bypass patient we were told they could not be treated for the stroke (with thrombolytic) due to the patient's history of warfarin use.

How does this fall under our protocol but outside theirs? If blood thinners (either in conjunction with a specific disease or as a certain dose) are a roadblock to thrombolytic therapy why isn't it listed as a contraindication to the bypass protocol? We did not have time to discuss the rationale behind the statement and have been wondering since if we misinterpreted the statement or if warfarin and similar drugs really do prevent thrombolytic use with CVA's? I know there have been studies linking problems with tPA in patients with warfarin history but didn't know that played an active role in the exclusion criteria at stroke centers now. If this is the case why not change the protocol to eliminate needless transport (especially when transporting from outside of the city/county where the center is located?

Question: On our ROSC protocol, the ONLY route that we are allowed to give a fluid bolus/dopamine is via an IV. Please confirm that we are NOT allowed to do so via IO or CVAD? This does vary from the IV and Fluid Therapy protocol which allows us to do so.

Question: Can you explain what this part in the consent section means? It seems to give more flexibility to not begin resuscitation based on family members who seem reliable saying that that is what the patient wanted. "If a paramedic is aware or is made aware that the person has a prior capable wish with respect to treatment, they must respect that wish (for example, if the person does not wish to be resuscitated)."

Question: Would bolusing a hypothermic ROSC be considered active rewarming?

Question: In the December 11, 2011 powerpoint on Termination of Resuscitation. The slide on page 37 states the Medical TOR applies to all medical VSA that are cardiac in nature and asphyxial in origin including hanging, drowning electrocution. The webinar from our recerts states Arrest thought to be non cardiac in origin, i.e. OD, Trauma, Hanging, Drowning are a contraindication to the TOR. Could you please clarify?

Question: Called to a nursing home for 90 year old male. On scene staff state patient has valid DNR but they are unable to produce it. The crew continues to resuscitate patient as per usual. Enroute to receiving facility, CACC advises the crew that family has phoned in and stated that they have the DNR and they do not want the patient resuscitated. The attendant phones the attending BHP and advises him of the situation. The BHP orders EMS to cease resuscitation efforts on patient. Is this right or wrong?

Question: Since we're now able to administer Epi for VSA Anaphylaxis, why are we not able to do so for Severe Asthma VSA?

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