Category Archives: Trauma Cardiac Arrest

Question: I was wondering if in the instance of a patient cutting their wrists, becoming hypovolemic and then going VSA if this should be treated as a medical arrest or a traumatic. Thank you in advance.

Question: In recerts we were informed that if we are extricating a patient who suffered blunt trauma and they go VSA in front of us. We are to run it as a medical arrest since it was witnessed? Is this true?

I just read a previous MAC post and it stated: ANSWER: Great question! Assuming this is a first arrest, the correct sequence would be to pull over, confirm the patient is VSA, begin CPR, and follow the Trauma Cardiac Arrest Medical Directive which includes one rhythm analysis.

Could you please clarify this?

Question: In regards to a traumatic VSA. The patient goes VSA during transport to the closest ER. The paramedic believes the arrest is of trauma origin. Do we pull over and perform one analysis and then resume transport? Or do we just do CPR until we arrive at the ER?

Question: I need some further clarification on the question "Seeking Clarification" from March 1 2012 regarding hypothermia. It has been my understanding that we DO NOT give medications to hypothermic VSA patients. I have clarified this before, unless this rule has changed since, so could you please readdress this part of the question for me?

Question: Seeking clarification: Traumatic Cardiac Arrest where TOR does not apply and we are transporting to nearest ER. While en-route, the medical directives currently state we are to transport with CPR and no further treatment. Is it acceptable to intubate if required, IV and epi q 4 min, consideration of bilateral chest needles? Would I require an order to proceed with the chest needles if patient is in PEA.

Same question for hypothermic arrest, is it permissible to intubate, IV access, patch for further orders, i.e. epi?

Question: Is the stipulation that the patient must be VSA upon arrival to qualify for a Trauma TOR is a SWORBHP deviation from the provincial directives? The protocol does not specifically state witnessed or unwitnessed arrest (as does the Medical TOR protocol). After talking to a couple paramedics under another Base Hospital they have informed me that they can Trauma TOR a witnessed traumatic VSA (for example, the patient goes VSA during extrication and meets all other criteria).

Question: This question is in regards to the TOR's and calling BHP. Some paramedic services lack having a spare cell phone while the primary cell phone for a truck is "out for service", missing etc. I have heard of some paramedics using their personal cell phones to call for the mandatory BHP patch for a pronouncement. I have spoken to Police and Crown Officials, and they have both stated that our personal phone can be submitted into evidence at an inquest or other matters, as this was the tool used to make that pronouncement (upon further investigation a paramedics credibility can be challenged as the court can see text messages, pictures, and phone calls placed on the personal phone). If our service fails to provide us with a cell phone for that shift for whatever reason, are we obligated to use our personal phone knowing it could be taking from us in an investigation for an unknown length of time? Would we document "no cell phone available" on the ACR?

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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