Category Archives: Medical Directives

Question: I see that it says consider NaCl bolus in the cardiac arrest standing order. In the past we gave a bolus for PEA as well as Rosc's. Can you confirm the exact circumstances we are to give the bolus as I find there to be a lot of gray areas in our orders.

Question: My question is regarding fluid bolus for DKA. Past practice has been to initiate a BHP patch for direction to administer a fluid bolus. The most recent Provincial Protocol states that a patch is only necessary for DKA in patients under 12. Are we still required to patch for a fluid bolus for adults in DKA?

Question: In regards to the new medical VSA directive: Would CO poisoning leading to VSA be considered an unusual circumstance? Thus performing one analysis and transporting would be acceptable?

Question: If I have a patient that appears to be in cardiogenic shock with a STEMI ECG should I be calling for a BH patch to have an order for aspirin after initiating an IV bolus?

Question: On page 11 of the new Medical Directives it states that vital signs have been kept constant throughout the directives and that any exceptions are clearly noted in each directive. Tachypnea is defined as 28 or > however, I noticed confusion amongst peers stating condition for CPAP was still at 24b/m or >. New protocol simply states tachypnea as the condition. Please clarify

Question: On page 2-29 it says "A single dose of atropine should be considered for second degree type II or third degree AV blocks with fluid bolus”. Does that mean fluid bolus for both or just third degree?

Question: Why was Lasix removed from the pre-hospital CHF/Pulmonary Edema protocol, when the first thing an ER Physician orders on arrival at the ER is Lasix?

Question: For combative patient, preference for route choice from left to right is IV then IM. Shouldn't it be IM first? It is kind of hard to get an IV on a combative patient. Why no IN anymore?

Question: Patient has a FBAO and a valid DNR (ex. nursing home). Resuscitate or not?

Question: Why did the dosing of salbutamol change by 100 mcg per administration? I am all for evidence-based changes to our protocols, but why such a small change? Surely the extra 100 mcg wasn't hurting anyone.

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