Category Archives: Miscellaneous

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?

Question: Is there any chance we will start giving acetaminophen to children with fevers (a temperature above 38 degrees) in the future? If not, what are the reasons why we can't add this to our protocols?

Question: On February 21, of this year the London Free Press had an article stating that the Middlesex London Health Unit plans to roll out naloxone kits to the public in hopes of preventing deaths from unintentional overdoses. Toronto Health Unit has already been distributing these kits. Why are Primary Care Paramedics still without this drug when Naloxone now in the hand of the public?

Question: In the thermal burns webinar very near the end, mention was made of London Fire carrying an ointment for treating burns. If Fire had not applied this prior to a paramedic taking over care for the patient, could the medic allow the ointment to be applied or apply it themselves? Or would this fall out of our scope of practice because such treatment isn't mentioned in the BLS or Medical Directives?

Question: Here is a question that has been up for debate from a few paramedics I work with. If you have a penetrating trauma, either in the chest or back, the BLS states to immobilize the object and transport to the best of your ability.

If the patient were to go VSA and the object was impeding CPR, either from the chest or back (not being able to do proper compressions), it was my understanding that we as paramedics are supposed to remove the object if we cannot do proper CPR instead of working around the object, which is the counter argument. What is the direction regarding this?

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