Date Archives: 20-Jun-2016

Category: CPAP   |   Date:

Question: I was going over the CPAP standing order today and would like clarification on whether the contraindication "Major trauma or burns to the head or torso" only means for a new occurrence or does it also include persons with prior existing major trauma or burns to head and torso?

Category: Nausea / Vomiting   |   Date:

Question: In regards to gravol. Pregnancy is not a contradiction but after doing research most medical journals state the following: because the studies in humans cannot rule out the possibility of harm, Dimenhydrinate should be used during pregnancy only if clearly needed. What are your thoughts?

Category: Intravenous and Fluid Therapy   |   Date:

Question: My question is regarding fluid bolus for DKA. There seems to be varying belief on whether or not a DKA patient must be hypotensive to administer a bolus. There is no specific language that I can find addressing bolus protocol for DKA other than the mandatory BHP patch point if the suspected DKA pt is 2-12yrs old, but this is listed under the NaCl fluid bolus protocol where hypotension is a condition for treatment. Just looking for a little clarification on the entire DKA bolus protocol.

Category: Cardiac Ischemia   |   Date:

Question: I am a ACP student and was discussing among my colleagues the proper time frame for vitals and drug administration for morphine and NTG in the cardiac ischemia medical directive. I understand that each drug has a 5 minute intervals but someone had mentioned that you could stagger both drugs in 5 minute intervals, for example after administering a third NTG wait 5 minutes then morphine then wait 5 minutes then NTG etc. I was wondering what the preferred interval for vital signs and drug administration would be with two drugs staggered at 5 minute intervals.

Category: Supraglottic Airway   |   Date:

Question: Can a PCP insert a King LT in a non-VSA patient with a GCS of 3 under the direction of an ACP?

Category: Medical Cardiac Arrest   |   Date:

Question: As per the question posted Feb 5th, 2014, if the FD shocks a patient prior to our arrival, we may count that shock into our protocol assuming we deem their care to adhere to AHA guidelines. In that setting, do we dial up to our second shock dose, or start at our first shock dose and dial up appropriately after that?

Category: Adult Analgesia   |   Date:

Question: The PCP adult analgesia directive is for "isolated extremity injuries", if there's more than one injury is it a contraindication? For example, burns to more than one location (shoulder and a portion of the ant chest) or an ankle and a knee injury.

Category: Trauma Cardiac Arrest   |   Date:

Question: If an 18 year old male hockey player was tackled and hit his face off the ice, has otorrhagea and and is VSA. First analysis shows asystole. Should he be treated under the trauma cardiac arrest directive or medical?

Category: Miscellaneous   |   Date:

Question: Are we required to complete a patient refusal and obtain a signature for any patient who for example refuses gravol administration, or does not want a medication given by IV, but accepts the medication administered IM, or refuses oxygen. Or any similar instance where there is a refusal, but the patient is still being transported to hospital.

Category: Miscellaneous   |   Date:

Question: My question is concerning the 5ml vials of Gravol and Toradol that some services are now carrying. Should these be thrown out after opening and removing one dose? Or are we to keep them and use them again for another patient?

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