Category Archives: BLS Patient Care Standards

Category: BLS Patient Care Standards, Oxygen Therapy, Covid-19   |   Date: , ,

In light of the COVID 19 crisis occurring and recent posting from the service about the use of the NRB in patients that are experiencing FREI symptoms and potential exposure to COVID 19 with low O2 sats and difficulty breathing, would the paramedics be supported by the Base Hospital if the patient only received a nasal cannula application at max flow rate of 6 lpm or if they were to use high concentration-low flow masks (Hi-OX, FloO2 system).

Category: Cardiogenic Shock, STEMI Bypass   |   Date:

The ALS PCS 4.5 STEMI directive follows the BLS V3.0.1 criteria and no longer has a pulse rate of <50 as a contraindication for bypass. Does this mean a bradycardic patient with a pulse in the 40’s can now be transported on a STEMI bypass? In the past medics where taught differing regions would have slightly different STEMI receiving acceptance criteria. Are there any considerations we as medics should consider for STEMI receiving hospitals in our governing region?

Category: Stroke Bypass   |   Date:

Are there any tools that we can use to differentiate Bell’s palsy from a CVA to prevent us from an unnecessary stroke bypass?

Category: Stroke Bypass   |   Date:

Question: In regards to the new BLS 3.0.1 under the paramedic prompt card for acute stroke protocol contraindications, it clearly states CTAS 2 and/or uncorrected airway, breathing or circulatory problem. My question in regards to this contraindication is does this automatically make a patient a CTAS level 1 when they are presenting with all signs and symptoms of a stroke and meet stroke protocol or does this mean that any other issues (i.e. chest pain making them a CTAS 2) puts them out of stroke protocol?

Category: Do Not Resuscitate (DNR)   |   Date:

Question: Are paramedics in Ontario authorized to adhere to a person's DNR wishes documented on a completed 'CCAC Plan of Treatment' as an alternative to a completed 'DNR Confirmation Form’?

Category: Trauma Patient   |   Date:

Question: With the introduction of commercial tourniquets and hemostatic dressings for Soft Tissue Injuries/Uncontrolled bleeds in the BLSPCS 3.0, where does the OBHG and MOH stand on wound packing for hemorrhage control? It is generally accepted among TCCC guidelines as a part of basic hemorrhage control, and even taught as a part of First Aid with some organizations. Unfortunately the BLS 3.0 (or 2.xx as well) do not explicitly mention it as an option, as well it is technically prohibited under the Registered Health Professions Act which lists "Putting an instrument, hand or finger, into an artificial opening in the body" as a delegated act. Is this something that we will see added to our scope in the future? Why or why not?

Category: Stroke Bypass   |   Date:

Question: Our current stroke directive reads that 3.5 hours is the timeline from time of onset to stroke center. The new BLS reads that the time from onset to stroke center is 4.5 hours. Which timeline are we expected to follow as of Dec 11th?

Category: Immobilization   |   Date:

Question: In regards to the BLS version 2.0 - extremity injury, bone/joint, there's a guideline regarding elbow dislocations. It says that if we encounter an elbow dislocation with nerovascular compromise, that we can contact receiving hospital or Base Hospital Physician for advice regarding manipulation or in-line traction. In the new BLS 3.0, this guideline has been left out. Are we still expected to perform the guideline if we ever encounter this, or has this been purposely taken out? Thank you.

Category: Do Not Resuscitate (DNR)   |   Date:

Question: When the Ministry of Health's DNR forms are filled out, can the section where the patient's name goes have a sticker from the hospital with the patients name/health card #/DOB, etc. instead of having the name printed or does that make the form invalid. The form specifically states the patient’s name should be printed clearly. I wasn't sure if the ID sticker was something we could accept instead or if that section can only be filled out by hand.

Category: Intravenous and Fluid Therapy, Do Not Resuscitate (DNR)   |   Date:

Question: In a setting where you arrive on scene and you are presented with a patient who is unconscious and is hypotensive, the patient has a valid DNR. Can you still administer fluids to this patient or does that fall under the same category as inserting an OPA/NPA and BVM to a patient with a DNR?

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