Date Archives: 12-Jun-2012

Question: Our medical cardiac arrest protocol states for pediatric patients consider initiating transportation following the first rhythm analysis that does not result in a defibrillation being delivered. My question is, "Until what age do we consider a patient a pediatric?”. Thanks in advance.

Question: I was just wondering the reasoning as to why we don't check for a pulse after we deliver a shock, and instead jump right into CPR? I have watched many VSA's ran in the ER and always see the ER physicians check for a pulse after delivering a shock before resuming CPR. I have asked several co-workers and no one seems to have an answer for this.

Question: I was just wondering how CVAD access should be documented on the ACR? There is no specific code for CVAD. Is it ok to document using the Normal Saline code (345) and just specify that it was via CVAD in remarks? Should I always get blood when I aspirate? (I didn’t but it seemed to flow well).

Question: I know there have been a lot of questions regarding the new cardiogenic pulmonary edema protocol. I am a student and just had a call regarding this. After the call there has been discussion about the directive and I have heard three different views and they are...

1. The first treatment column <140 you can ONLY give NTG if a IV is established (no hx.) 2. The second column stating that =>140 with no hx or Iv you can give 0.4mg is to be completely disregarded as it contraindicate the directives conditions 3. The third column stating that =>140 give 0.8mg ONLY if an IV is established (no hx.)

So the question I am asking is can you please clarify the treatment chart of the acute pulmonary edema directive?

Question: We are transporting a patient from a small hospital without a CT scanner to a larger hospital with a CT scanner but not a Stroke Centre. Our patient is an obvious stroke patient...slurred speech for over 1 day, but is getting better and no other issues...stable, but still with slurred speech (does not meet Stroke Protocol as onset over 24hrs).

What should we do should this patient become worse enroute to the CT capable hospital? Say his slurred speech becomes worse or he shows other signs and symptoms? Is this considered a "new onset" or a continuation of his current CVA/TIA? If "new onset" I would think he now meets the Stroke Protocol and should be diverted to the Stroke Centre? Could you please clarify?