Date Archives: 2022-01-19

Would the presence of De Winter T waves be enough to transport the patient to the cath lab. I know its considered a STEMI equivalent but there is no actual ST elevation.

The AHA and COVID-19 guideline has a caveat that states in "suspected or confirmed COVID-19 cases" we should implement the prescribed practices. In the event that the patient in cardiac arrest is not confirmed or suspected to have COVID-19 symptoms is it reasonable to every to pre-pandemic practice of resuscitation?

Does a prescription of NTG patch count as previous history of use for NTG spray? Would it be a concern that the medication would be administered through a different route and therefore have a different onset of effect?

Antiemetics: unrelated to our current directives but I was just wondering what the rationale was for specifically using dimenhydrinate as our prehospital antiemetic option? As I understand it, and I've had a number of conversations with physicians of different disciplines regarding the same, dimenhydrinate is most effective for motion sickness, and other antiemetics exist that are typically more effective for the types of emesis that we typically deal with in the field.

When dealing with an anaphylactic patient, the PCP medical directive says to administer up to 2 doses of epi at a maximum single dose of 0.5mg, whereas the bronchoconstriction AND cardiac arrest medical directives are only one dose at a maximum single dose of 0.5mg. Can some explain why?

I have had a few calls to nursing homes where the patient’s IV fell out and the patient is being sent to the hospital for an IV restart. If the patient does not have any complaints otherwise, would an IV certified crew be able to start the IV and patch to not have the patient transported? If so, would this be documented as a refusal? I have always transported these patients but it would be helpful to know if there are other options to avoid an unnecessary trip to the hospital. Thank you!

The updated AHA guidelines indicate an increase in the ventilation rate to 20-30 breaths per minute for children and infants respective in INTUBATED patients. Does this apply to patients who have a supraglottic airway in situ as well? Thank you!

Follow-up question that was asked on 29-Jan-2021 about pulse checks after no shock is indicated. Base hospital answered that pulse checks should occur concurrently with each rhythm analysis. Is this true for those of us that are using S-AEDs rather than manual rhythm analysis? The reason I ask is because First Aid & CPR courses suggest that touching a patient during an AED analysis will introduce artifact that could affect the accuracy of the analysis.