Why is the pain management protocol for cardiac ischemia written in a way to limit pain medication use until the patient reports a 7/10 or greater, especially given that while a patients "pain is what they say it is", as a numeric scale it is still subjective to the patients experience. This encourages providers to lead the patient to a specific end. Thank you.
What is the difference between home CPAP for sleep apnea and CPAP we carry/our medical directive? Why can people with sleep apnea can use CPAP while sleeping (not sitting upright) and our medical directive doesn't allow (contraindication if patient cannot sleep upright)?
Tachydysrhythmia- conversation with ACP's regarding Adnenosine. Case in point, ACP treated patient with 6mg IVP, no change in rhythm but the BP dropped to 96 systolic. This patient fell into the zone of no more adensone and was not hypotensive (less than 90) for PATCH cardioversion. Minutes later patient normal tensive...can you treat again with adenosine or is it the same as once your out your out?
Just recently did an inferior MI pt with ST elevation in II, III and avf with reciprocal changes to V3 to V6. We did a 15 lead by putting v4 on the right side and it was negative. His pressure was systolic 160 . I gave the pt so e ASA but was confused if Nitro should of been given therefore I didn't give any. We were both PCP . Should Nitro be given if the 15 lead is negative? And follow the STEMI protocol?
When it is determined the patient is experiencing cardiac ischemia and also presenting with acute pulmonary edema (IV established, BP over 140) should the treatment plan only include 0.4mg doses of nitro x6 and try CPAP? Or can nitro be administered to the 0.8mg as stated in the edema directive? My opinion would be to only treat with 0.4mg nitro.
VSA patient with a verbal DNR from spouse. In a PCP/ACP split crew situation would the expectation be for the ACP to do the patch to the BHP to authorize the honouring of the verbal DNR or can it be either crew member depending on whom is most available in the situation? Basically, should the ACP generally be patching even if it is for things within the PCP scope of practice "just in case" the BHP wants to discuss other, expanded treatment options?