Category Archives: Miscellaneous

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?

Question: How often should you reassess the respiratory rate for apneic patients?

Question: In which instance should a transdermal patch be removed in the pre-hospital setting? Example 1: Hypotensive patient with a Nitro patch on. Example 2: VSA with a narcotic patch on. Example 3: Suspected OD with a narcotic patch on (or several).

Question: If a doctor is someone who can assume care of a VSA patient and decide to have resuscitative efforts ceased, then why is a doctor not someone who counts as a witness in the 'unwitnessed arrest' condition of a TOR, along with paramedics and firefighters? Thanks in advance.

Question: I have a question about postictal patients and cardiac monitoring. I have been told two things by several other partners in past few weeks. Assume you are a regular seizure patient whom you have seen many times and he/she is in their normal postictal state and you are not suspecting brain trauma. Is there any clinical reason/need to put cardiac monitor (e.g. limb leads) on? Also assuming you have a 1 min transport time. I was told as per BLS standard you "must" but in the postictal section it mentions that the paramedic may consider enroute. Thanks.

Question: I have recently came across a situation where an ACP/PCP crew decided to have the non-IV cert PCP attend a Stroke Protocol call, and the ACP replied that he/she did not think it was necessary. Because the protocol requests a IV be established whenever possible, should the ACP have attempted an IV and attended?

Question: I am just curious as to why SWORBHP or MAC has opted to pull the android/iPhone medical directives app? This was a great tool if a quick refresh was needed while en route to a call. I realize we should all know our protocols inside out, but sometimes a quick reference for reassurance is needed. I was under the impression when the app was pulled it was perhaps for a further refinement/usability and we would be seeing it again soon. It makes no sense that a tool like this was given to us then pulled back. Also, it's a great tool for SWORBHP to update any protocol changes from year to year as you are no longer supplying us with books.

Question: Are there contraindications for sager applications?

Question: I have a question regarding an MCI scenario. There is a total of 10 patients; 3 patients are dead from trauma and 7 patients are cleared off scene from other ambulances. You now have the 3 black tag patients left. Do we need to re-assess these patients and get trauma TOR for each one?

1 2 3 4 5 7