In the case where vascular access CANNOT be established, could the base hospital clarify what the recommended solution of epinephrine should be when administering endotracheally during a cardiac arrest.
In the event of a ROSC followed by a rearrest is an ACP medic to continue administering EPI every 4 minutes or are we only to do the one analyze and continue CPR till receiving hospital? I seems like epi could be beneficial to the pt in re arrest as well as potential amnio however the directive nor the companion document seem to answer this question.
I have worked at two other services which ONLY carried Ventolin 2.5mg/2.5ml. to get the adult dose of 5mg we just used 2x2.5mg/2.5ml
Here in Ottawa, we carry both 2.5/2.5 and 5/2.5 concentrations and I had a partner tell me we are supposed to only use 5mg/2.5ml for adult admin as it is due to higher concentration and my partner was telling me I am being a detriment to my patient by using 2x 2.5mg/2.5mls as it takes twice as long to take effect. (According to partner)
My question is does it matter which way we administer it if it is the same dose? And both ways meet our protocol technically.
Me personally, I have always felt like I wanted it to last as long as possible hence why I like using 2.5mg in 2.5ml as it gives you 5mls of solution. which is why we only carried that at the other services as we had long transport times.
As a First Response PCP (PRU or Sierra) if I am on scene with a VSA and I perform a shock for V/F or V-Tach and I end up at the end of my protocol (3+1 analysis) and the PT remains VSA and no transport crew is on-scene yet, should I just continue doing analysis every 2 minutes until they arrive? (Other first response agencies use this as their protocol until ambulance arrive).
Obviously this would change if I hadn't gotten a shock and I had to concider a medical TOR after my 3+1analysis.
Did a trauma VSA, where I called for a TOR. Pt fit the criteria: no palpable pulse, no shock delivered, and monitored HR=0. However my QA supervisor told me I should be putting on the limb leads, and cycle through leads to confirm HR is actually 0, and that it was not fine v-fib.
Is the defib pads not enough to confirm asystole? Does RPPEO want limb leads on trauma VSA? and are we do do that for medical VSA?
Can we use the proximal humerus as an access site for an IO under the Adult Intraosseous Medical Directive without patching?
After research in the Companion Document, the current ALS PCS and the Intraosseous Site Guideline (under the Medical Reference Tab in the OPCG app), there doesn't seem to be any restriction on the location for an IO access in the RPPEO. Are ACPs allowed to do this without patching?
You have a patient who has a prior history of nitro use and BP greater than 140 and you administer Nitro 0.8 mg SL under the Acute Cardiogenic Pulmonary Edema protocol. What dose of nitro do you administer if the patients BP drops below 140 but remains above 100 and doesn't drop by 1/3? Are you to continue with 0.8 mg or drop to 0.4mg?