Date Archives: March-13-2023

The vial of dexamethasone does not say that it can be given orally. Is it safe to give this route?

I have a scenario that happened and would like to know what the right answer is. We had a patient feeling generally unwell and dizzy. I performed a stroke assessment and he had equal grip strength, no pronator drift, and could raise both of his legs. There was no facial droop, slurred speech, or unilateral weakness. When we were transporting we noticed the patient was severely leaning to the right. He couldn’t support himself upright at all, but everything else remained intact. Is this enough evidence to count as unilateral weakness? Would you stroke bypass?

This is a BLS question. For management of a flail chest, most research suggests that we tape the flail segment in place with a large bulky dressing, bag of saline, Asherman chest seal, etc. I've been hearing from recent PCP graduates that they have been taught to use a bulky dressing, however they mention that they are being taught to do a circumferential wrap around the chest with a triangular bandage or blanket to hold the dressing in place (which I would assume is incorrect) instead of taping a bulky dressing over the flail segment. What would be the preferred method and why?

Hello! Question for you. If we have a patient who is complaining of unilateral weakness or numbness, but on exam has equal grip strength, no facial droop or slurred speech, and equal strength in both legs, what would be the appropriate destination? Should we still stroke bypass to the nearest stroke center? To clarify, the patient feels as though they have weakness or numbness on one side of their body, but we are unable to find any deficits on our physical stroke exam (LAMS score of zero).

Question from an ACP role, For a pediatric patient who has a HR less than 60 with poor signs of perfusion (cyanosis/pale and apneic…..start chest compressions with airway and ventilations via BVM. The question is do we follow it up with epi? In the PALS algorithm it states to do CPR/ventilations, epi, atropine and consider pacing. This is covered under the newborn arrest directive however it is not covered under the adult/pediatric medical cardiac arrest. What does our base hospital want us to? Would it be appropriate to follow the PALS Bradycardia algorithm?

Why does Ketorolac in the Analgesia Medical Directive have normotensive as a condition, when other NSAID directives do not include a SBP condition?

Can you confirm that the change in dose from 0.8 to 0.4 IM was simply because we are trying not to wake these patients up?

If a patient is capable - why is there a section for "Emergency Treatment of a Capable Patient without Consent"?

A patient that sustained a head injury and initially presented in an altered state. The patient then improved to an unaltered state, and presented with Nausea/Vomiting, does the patient qualify for Ondansetron administration?

Why are we waiting to implement the cardiac arrest medical directive changes until Feb?

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