Date Archives: 5-Feb-2014

Question: The medical directives state that in order to call for a medical TOR one of the conditions is for the arrest to not be witnessed by EMS.

Does this just refer to EMS or does it include other emergency services, such as Nurses, Fire, Police or PSW? For example if PSW or Fire witnessed the arrest before EMS arrival and EMS arrived on scene and completed 4 analyzes and no shocks delivered, can EMS still call for a TOR because it was not witnessed by EMS?


Question: Can ALS take a pronouncement from the on-scene doctor at a retirement home? I ran the code, since the patient was full code, and got a pronouncement on the phone with the BHP. Once we stopped care, the guy who had been watching us, said that he was her doctor and didn't think we would get her back.

I was wondering if that the on-scene doctor had said something at the beginning of the call, could I just ask him for the pronouncement instead of waiting for the BHP to come to the telephone? We cleared it with management to leave care with that doctor since police didn't come to the scene to call the coroner and take over. Otherwise we would wait for police until we left scene.

Question: If an IV certified paramedic with a non-IV certified partner initiates a saline lock but does not give fluid or medication; can the partner without IV certification attend the call?

Question: Whilst completing my pre-course recertification material, we were asked a question with regards to blood glucose testing. Following administration of med for hypoglycemia, the question asked when next should you do a blood glucose test. I had guessed after 5 min although re-dosing would not be for 10 or 20 min depending on drug used. I guessed wrong apparently.

The other choices would have been:
a) With EVERY vitals post treatment (what about a long off load, we might do 3 or 4 more sets of vitals!)
b) After no improvement (no time noted and they might not show no improvement for a few minutes and sticking them after just two would be unnecessary)
c) Once at the hospital (that would disallow the re-administration of a second dose of treatment.)

Question: With regards to EPI administration, presumably under the Bronchoconstriction directive. We do not have auto-injectors in the service I work in. Our directives indicate ONE administration via IM. My question is regarding the patient's previous use of their own auto-injector. I would assume that if they still met our protocol showing appropriate signs and symptoms, that their injector did not work and I would administer our EPI IM once only. Thoughts?

Question: My question is regarding Traumatic TOR caused by penetrating injury. I have been informed that penetrating trauma TOR is only allowed if it involves the head or torso. Is this correct or is it anywhere on the body? Thanks.