Category Archives: Miscellaneous

Question: My question is concerning the 5ml vials of Gravol and Toradol that some services are now carrying. Should these be thrown out after opening and removing one dose? Or are we to keep them and use them again for another patient?

Question: How can we deal with doctors at clinics that abuse the EMS system? We frequently go to these clinics, lights and sirens, only to arrive with a non-emergency call. More often than not, the patient states "the doctor called you guys, because she said I will get in quicker than driving in by car." It gets very aggravating when the general public abuse the medical system, but when a medical doctor does it, that is way worse.

Question: Is it advised that when a patient is not adequately perfusing but still technically with a pulse, that CPR be commenced? In discussing this with my colleagues, we are speaking in regards to a patient who may technically still have an idioventricular or agonal pulse and is circling the drain. Instead of waiting the 30 sec-1 min for the patient to be completely VSA, would it not be better to get on the chest and begin compressions in an attempt at increasing perfusion?

Question: I have heard the term "best practice" used quite often in the past little while. I was wondering if you could elaborate on the means of "best practice", and if the SWORBHP guidelines can be considered "best practice"?

If not, where would one look to ensure they are using the "best practice"? For example, in recent studies, best practice may not be to administer oxygen to each and every patient, however the BLS states that we should administer oxygen to each patient.

Question: There has been a great deal written lately about the use of the long spine board (LSB) and its use in prehospital care. Many jurisdictions have eliminated or curtailed the use of the LSB due to the lack of clinical evidence supporting its benefit and the growing evidence that it actually increases morbidity and mortality in many types of patients. When is MAC going to examine this issue and hopefully revise the Standards to reflect the current knowledge base?

Question: In regards to the base hospital recertification for 2014-2015, in the video for medical cardiac arrest the paramedic received a ROSC and was re-evaluating vitals q1 minutes, however, in the quiz it was noted that you are to re-evaluated vitals q3-5 minutes. Can you please clarify?

Question: Your partner is preparing O2, obtaining vitals and attaching the monitor for a chest pain patient. You are performing a primary survey, gathering your SAMPLE Hx, ruling the patient in protocol for ASA, giving the ASA and doing the same for Nitro. Vitals are obtained 3-4 minutes earlier than the Nitro administration.

From past experience and following the protocol which states vitals q5 min, nitro q5 min and vitals must be obtained within 5 minutes of medication delivery, is this improper as 3 minutes has lapsed prior to the nitro administration? I have been informed that past deactivation has resulted from this?

Question: Can an obstruction of the esophagus cause an obstruction of the airway?

Question: There was a question posted on Sep 23, 2014 in regards to a fluid bolus on a transfer between facilities. As I agree that there should have been an RN escort for this patient, the paramedic was certified in IV fluid therapy including boluses. Your answer has me perplexed however. If a physician gave the paramedic a fluid bolus order how would that differ from getting a similar order from a BHP through phone patch. It is in the scope of practice for the paramedic to administer NaCl 0.9% as a bolus, the volume was prescribed by the physician(s) in charge of this patient's care. Would any paramedic be wrong in following the order given by the physician?

Question: What is the criteria necessary for the starting process of implementing a new directive/protocol for pre-hospital settings?

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