Date Archives: 2021-september-17

In the Toradol protocol it simply uses term "current/active bleed" as a contraindication, the companion document provides little clarification as to how this applies to trauma pts as trauma was removed as a contraindication. Would trauma with high index of suspicion for internal bleeding (MVC, Motorcycle accident, fall from height) be a contraindication? Would multisystem trauma pts? Or would the better course of action be to treat their pain? Thanks!

Is there anywhere to go and practice scenarios with an educator for those of us who learn better hands on and want to freshen up on some skills and directive (including the companion doc, and bypass rules)?

What is the correct course of action if a pt goes VSA while crew is on scene, (ex. 1st analyses reveals VF, pt shocked, then 2 more analyses 2 min apart- both PEA), then pt starts spontaneously breathing and has pulse (ROSC)...then rearrests 2 min later and is in VF so crew shocks...CPR continued as pt still pulseless. Keep in mind crew is still on scene waiting for fire to show up as crew needs help with extrication.. this situation has happened and 1 crew member had called BHP for direction as it's 'grey" area as normally you are transporting by then and would do 1 analysis following rearrest and shock if necessary and continue with transport/CPR.. BHP was not clear just kept saying "follow your protocol" when in fact the crew was but at that point was very "grey". Would we treat it as a whole new medical cardiac arrest protocol as its a re-arrest on scene until fire arrives? Or what would be the best course of action?

You have a patient that is VSA from penetrating trauma. The bls states you transport to trauma hospital if less than 30 min. The als pcs states that if your patient VSA from trauma and a TOR does not apply (pt in PEA) you transport to closet ED. So which one is correct the BLS to trauma hospital or ALSPCS to closest ED.

Why do the pandemic guidelines allow for the administration of 2 doses of epinephrine (<50y) in bronchoconstriction (asthma exacerbation) vs the ALS PCS allowing only a single dose (without age guideline)?