Category Archives: Tip of the Week

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

Posted on: November 25, 2020

2020 MCME Tip of the Week: Orders Can ONLY Be Taken from a Base Hospital Physician

From the Grey Zone presentation: Orders for treatment of a patient under your care (including on off-load delay) can only be taken from a BHP. A nurse cannot tell you to discontinue your Medical Directive unless transfer of care has taken place and you are no longer caring for or following your Medical Directive (or upon certain hospitals wherein shared-agreements exist such as STEMI-Bypass and care is shared responsibility and differs from the Medical Directive).

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2020 MCME Tip of the Week: Adult vs Pediatric Arrest Dosages

2020 MCME Tip of the Week: Adult vs Pediatric Arrest Dosages

Posted on: November 18th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Remember that the age cut-off for adult Epi and Antiarrhythmic medication in Cardiac Arrest is ≥12 years-old.

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2020 MCME Tip of the Week: Don’t Let Hospital Proximity Distract Your Resuscitation

2020 MCME Tip of the Week: Don’t Let Hospital Proximity Distract Your Resuscitation

Posted on: November 4th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Hospital Proximity should not typically play a role in decision to transport. Unless the patient has a potentially reversible cause of arrest that cannot be treated prehospitally, they should receive the best possible resuscitation in the field before consideration for transport. Don’t let hospital proximity distract you from your lifesaving resuscitation!

*Thanks to our PHCS Micheal Filiault for this awesome reminder

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2020 MCME Tip of the Week: Adult vs Pediatric Defibrillation Settings

2020 MCME Tip of the Week: Adult vs Pediatric Defibrillation Settings

Posted on: October 28th, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

From the Grey Zone presentation: Remember that the age cut-off for adult defibrillation settings is ≥ 8 years-old. Think Electricity – Thomas Edison – EIGHT.

*Thanks to our PHCS Tony Jaroszewicz for this memory aide

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2020 MCME Tip of the Week: 12-Lead ECG QT Eyeball Method

2020 MCME Tip of the Week: 12-Lead ECG QT Eyeball Method

Posted on: October 16th, 2020

2020 MCME Tip of the Week: 12-Lead ECG QT Eyeball Method

Eyeball method for measuring the QT interval: If the T wave ENDS at greater than 1/2 the distance between the R-to-R interval, this means the QT is likely prolonged (>500 msec).

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2020 MCME Tip of the Week: ACP Management of VT with Pulse Requires a BHP Patch

2020 MCME Tip of the Week: ACP Management of VT with Pulse Requires a BHP Patch

Posted on: September 30th, 2020

2020 MCME Tip of the Week: ACP Management of VT with Pulse Requires a BHP Patch

From the Online ACP Case Study VT with Pulse Module: Per the Tachydysrhythmia Medical Directive, BOTH cardioversion for unstable patients and amiodarone/lidocaine administration for stable patients requires a BHP patch/order.

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2020 MCME Tip of the Week: When to Call for TOR or Direction in Trauma vs Medical Cardiac Arrest

2020 MCME Tip of the Week: When to Call for TOR or Direction in Trauma vs Medical Cardiac Arrest

Posted on: December 2nd, 2020

2020 MCME Tip of the Week: When to Call for TOR or Direction in Trauma vs Medical Cardiac Arrest

From the Grey Zone presentation: Remember that a Trauma TOR is called for after the 1st analysis versus a Medical TOR (or direction/pronouncement) wherein the Mandatory Provincial Patch Point is after the 3rd analysis or round of Epinephrine.

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Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

Posted on: September 23rd, 2020

Considerations for Paramedics Managing Patients during the COVID-19 Pandemic

There have been 3 iterations of the OBHG “Consideration for Paramedics Managing Patients during the COVID-19 Pandemic”. Please refer to and utilize the most recent version (here), which outlines changes to current practices.  The changes to practice within the first two iterations is not in addition to the considerations within the most current version.

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Trach re-insertion still allowed during the pandemic

Proper Airway Positioning of the Morbidly Obese Patient

Posted on: September 16th, 2020

Trach re-insertion still allowed during the pandemic

Remember that tracheostomy tube re-insertion per the Emergency Tracheostomy Tube Reinsertion Medical Directive, is still to be performed (with appropriate PPE) during the COVID-19 pandemic.  Since the initial recommendations (Feb 6, 2020) paramedics are to consider withholding suction via an endotracheal or tracheostomy tube unless using a closed-system unit.  However, re-insertion is still a life-saving and allowable procedure during the pandemic.

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Proper Airway Positioning of the Morbidly Obese Patient

Proper Airway Positioning of the Morbidly Obese Patient

Posted on: September 11th, 2020
Intranasal Medication STILL Out When Another Route ExistsProper positioning is extremely important in morbidly obese patients, to alleviate obstruction and optimize ventilation.

During intubation, proper positioning will improve your chance for success and it will also help bring the trachea into view.

This picture illustrates the “ear-to-sternal notch” positioning ideal for morbidly obese patients.  Notice the amount of sheets and blankets used.

Remember, obese patients have the same internal anatomy as lean patients of the same height (ex. Similar lung volumes, the distance from the mouth to the lungs is similar).  However, excess tissue causes:

  • Impaired laryngoscopy visualization – which means you want to optimize your technique with the ear-to-sternal notch positioning
  • Increased oxygen demand and decreased reserve – these patients desaturate quickly!

THEREFORE, make sure to set yourself up for success with optimizing positioning and pre/peri-oxygenation as much as possible.

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