Date Archives: 28-Nov-2017

Question: With the introduction of commercial tourniquets and hemostatic dressings for Soft Tissue Injuries/Uncontrolled bleeds in the BLSPCS 3.0, where does the OBHG and MOH stand on wound packing for hemorrhage control? It is generally accepted among TCCC guidelines as a part of basic hemorrhage control, and even taught as a part of First Aid with some organizations. Unfortunately the BLS 3.0 (or 2.xx as well) do not explicitly mention it as an option, as well it is technically prohibited under the Registered Health Professions Act which lists "Putting an instrument, hand or finger, into an artificial opening in the body" as a delegated act. Is this something that we will see added to our scope in the future? Why or why not?

Question: This question is in regards to hypoglycemia mimicking a stroke. You arrive on scene and the patient is presenting with the classic signs of a stroke such as facial droop, arm drift etc. Patient is out of the stroke protocol since GCS was <10, and the patient was terminally ill due to cancer, with a valid DNR. I obtain a BGL and the BS comes back as a 3.0mmol, so I correct the hypoglycemic event. Moments later a second BS was taken and it comes back as 4.1mmol. Another stroke assessment was done, with no signs and or symptoms of a stroke. Patient then complains of severe cancer related pain in her abdomen. My question is now, would I have been save in not giving the patient any NSAIDS since one of the contraindications was "CVA or TBI within previous 24 hours?" I ended up giving Acetaminophen since I thought doing something is better than nothing for the patient’s abdomen pain. Along with that, I didn't know if the patient experienced both a CVA and a Hypoglycemic event together at the same time, or if the patient experienced a stroke hidden in with the hypoglycemic event. What are your thoughts?

Question: In the Bronchoconstriction Medical Directive, would a patient ever receive salbutamol followed by epinephrine? Is epi there in case that the patient does not respond to salbutamol and instead gets worse after salbutamol administration? If the patient does not require epi at first, but instead is given salbutamol, then gets worse requiring epi, could that epi administration follow with salbutamol again?

Question: The new BLS that will be introduced in December 11, 2017 mentions that treatment and transport refusal would require the completion of the refusal of service. The question is whether it is required to be completed for any refusal of treatment or just treatment with possible negative outcome to patient example refusing collar vs. Dimenhydrinate or any analgesic?

Question: Our current stroke directive reads that 3.5 hours is the timeline from time of onset to stroke center. The new BLS reads that the time from onset to stroke center is 4.5 hours. Which timeline are we expected to follow as of Dec 11th?

Question: How can someone differentiate between crackles found in Acute Cardiogenic Pulmonary Edema between those found in pneumonia?