Date Archives: 28-Mar-2019

How should I proceed if the patient I’m treating tells me that they have already self-administered Gravol, within the past hour, but has since vomited multiple times. Do I proceed with IV Gravol as she has likely thrown up her self-administered dose?

Why isn't there a "febrile medical directive" to give Tylenol? having something like this especially around flu season would enhance patient care.

I have a question regarding our new Emergency Childbirth Medical Directive. My understanding from the protocol is that we can stay on scene to deliver a breech presentation, but for a limb presentation we must transport immediately. I know that we can deliver a complete breech and a frank breech, but what about a footling breech? Is that considered to be a limb presentation that requires immediate transport?”

If I want a faster onset of pain relief can I go straight to Ketorolac IV?

Do we HAVE to take a 12 lead to diagnose SVT?

If I am in a first response truck and have no shocks, do I have to wait until the transporting unit gets there to call for a TOR or can I call when I meet all the criteria?

The ALS PCS 4.5 STEMI directive follows the BLS V3.0.1 criteria and no longer has a pulse rate of <50 as a contraindication for bypass. Does this mean a bradycardic patient with a pulse in the 40’s can now be transported on a STEMI bypass? In the past medics where taught differing regions would have slightly different STEMI receiving acceptance criteria. Are there any considerations we as medics should consider for STEMI receiving hospitals in our governing region?

Our directives state that we are allowed to administer 2 doses of epinephrine to a patient suffering from a severe allergic reaction and 1 does to a VSA patient who is expected to have become VSA secondary to anaphylactic shock. Does this mean we are allowed to give a 2nd and possibly 3rd dose of epinephrine to a patient by following the moderate to severe allergic reaction medical directive post ROSC?

Wondering what your thoughts are in regards to administering nitro to a patient with atypical angina symptoms and no presentation of chest pain. For example, is it ok for us to administer nitroglycerin if a medic is presented with a female patient who states she becomes nauseated from angina and explains she is prescribed nitro for the symptom? I discussed this question with my colleagues and I have found there is a 50/50 split in regards to those of us who would use nitro or not. I think it is a good question to ask given the differencing of opinion in the field.

Are there any expected changes coming in regards to transporting an organ donor VSA patient? Is there a more appropriate receiving facility to consider and what should we do with an organ donors body after obtaining a TOR?

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