Date Archives: 04-Feb-2020

My question comes from the Medical Cardiac Arrest Directive and specifically in relation to the clinical considerations section. I have two questions relating to this.

First of all, the medical directive lists medication overdose/toxicology as a circumstance where the paramedic can consider very early transport after the 1st analysis. My question is can this also apply to overdoses from recreational drugs? It touches on cardiac arrest with associated opioid overdose but doesn't go into great detail besides the role of naloxone in these circumstances.

Secondly, it lists pediatric cardiac arrest as a situation where we the paramedics are to plan for extrication and transport after 3 analysis. However due to the rarity of this circumstance and the likelihood of its origin resulting from a reversible cause would the paramedic be correct in transporting these patients immediately following the 1st analysis?

How does SWORBHP suggest measuring the correct dose of Hydroxycobalamin to a pediatric patient? The Cyanokit is provided as vials that are to be reconstituted with normal salient diluent. The pediatric dose is 70mg/kg, given over 30 minutes. Unlike our other pediatric-dosed medications, this system does not allow for us to easily measure the exact dose given as there are no mL markings on the bottles. Sny help is greatly appreciated.

Is a suspected pelvic fracture a contraindication to IO in the tibia?

With respect to the Suspected Adrenal Crisis Medical Directive from the ALS PCS, I'm wondering what specific medical conditions would fall under this umbrella because the only one I am familiar with is Addison's?

For a VSA patient who is in refractory vfib after 3 analyses, can we call BHP for double sequential defibrillation if we have a second PCP unit?

As PCPs are we allowed diluting Narcan 0.4mg/ml 1:9 with NS when giving it IV route? (0.04mg/10ml) titrate to effect.

For pediatric patients, are we supposed to get orders solely from pediatric physicians or can we get orders from physicians an adult ED? Are the pediatric physicians also in the base hospital program?