Paramedic Practice

A friend of mine is a MD in palliative care. In the recent few months three of her patients were discharge home for end of life with a still functional ICD. In all cases patient wanted the ICD disabled once they realised it would prolonged their ago…

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Question# 883

STEMI contiguous leads

My colleagues and I are not all on the same page. When looking at an ecg and looking for elevation in "2 or more contiguous leads" would v2-v3 count as contiguous, same idea for v4-v5 or are we only grouping (v1/v2, v3/v4, v5/v6/1/avL, 2/3/avf). Are…

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Question# 877

Topping Up Patient Medications

When arriving to a patient that has taken a medication prior to Paramedic arrival but not full dose - for example only 325mg or 500mg Tylenol - are we to not administer any more Tylenol or are we expected to top up the dose to a full 975mg? Same que…

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Question# 855

Intervening on a flight

Recently, I had to intervene on a plane during a transatlantic flight for an elderly patient who first appeared to be VSA in her seat. I was the most qualified medical professional on board. I was provided their emergency kit, and tried to figure ou…

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Question# 860

Disclosing Information

I had a pt confess to a serious crime while intoxicated. Would it be appropriate to pass on this information to the appropriate police force? Not including any patient medical history obviously

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Question# 834

Heated blankets for hypothermic/trauma patients

What is RPPEO's stance on the use of one time use heated blankets, with patients who are either hypothermic, or have suffered multi-system trauma?

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Question# 811

Do we need to reassess patients in an MCI?

In the case of an MCI where one (or more) patients are VSA, when patients are initially triaged as "black" and do not be the criteria for obviously dead, should resuscitation be attempted if/when enough resources have arrived on scene?

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Question# 795

Palliative Care Medications

Can you administer palliative medications to a palliative pt. if transport to hospital has been initiated? Does this require a patch? Is this applicable for any/all palliative meds or only select ones? Can you patch to administer palliative meds to…

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Question# 766

Rigor Mortis

My question pertains to obvious signs of death, and specifically with respect to rigor mortis of the smaller muscles of the face. I recognize the standard for obvious signs of death as documented by the RPPEO is "gross rigor mortis" ie stiffening o…

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Question# 762

Flail Chest Management

Regarding a flail chest, what is the RPPEO’s preferred treatment? There is conflicting data on whether to splint and do PPV. What is the RPPEO’s stance?

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Question# 749

Defib Pad Placement

Does the RPPEO have a stance with respect to defibrillator pad placement?

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Question# 747

Trauma VSA Transport Times

Following up on question #738 Trauma Timelines answered on October 16th, Currently in our OPCG Base Hospital app in the Destination Guidelines under Pediatric Bypass, there is a category for "greater than or equal to 16 years old, penetrating traum…

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Question# 752

Posterior STEMI Bypass

In regards to STEMI protocol and bypass, does it apply to posterior STEMI? The colored coded card in the protocol booklet only shows lateral, inferior, septal, anterior. I understand we would still treat the patient under the cardiac ischemia protoc…

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Question# 744

MAP vs. BP

Knowing that monitoring devices, (LP15/Zoll), use oscillometry to accurately detect MAP and not SIBP, have the MOH and BHs made any strides in reviewing and changing all medical directives to reflect MAP as the accurate measure of hypo-perfusion and…

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Question# 751

SET Protocol

Is SET protocol still the expectation from the RPPEO, why or why not? Should we still have the receiving hospital sign off on tube placement once TOC in the event of a Coroner's inquest? This was part of the protocol along with a c-collar and ETCO2/…

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Question# 719

Rounding Medication Doses

When preparing medication, for example IM Midazolam for a 36kg pt, the 0.2mg/kg dose would be 7.2mg. Using a 5mg/ml concentration that would be 1.44ml volume of medication. Using a 3ml syringe, I would only be able to accurately measure 1.4ml dose…

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Question# 714

Palliative Care Medications

With palliative care directives now becoming a core directive, what is the RPPEOs stance on using these medications for general practice. Examples include: using hydromorphone for pain management for someone who has previous hx of hydromorphone use…

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Question# 707

PCP AIV Ondansetron Administration

Within the palliative care directive, PCP’s can only give odanestron PO/SC. Can AIV PCP’s give odanestron IV?

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Question# 688

Pediatric Airway Equipment Dead Space

Question received from a paramedic in regards to the length of the "tree" (filter, ETCO2, tube extender) at the end of a SGA - iGel in our case - for pediatrics. Has previously been taught that this should be minimized due to tidal volume of pediatr…

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Appropriate BP Site

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Intranasal Dexamethasone

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Postural Vital Signs

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STEMI + and Transport to PCI Timeline

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Paramedic Practice

Pediatric Nasal Suctioning

ICD Deactivation

STEMI contiguous leads

Topping Up Patient Medications

Intervening on a flight

Disclosing Information

Heated blankets for hypothermic/trauma patients

Do we need to reassess patients in an MCI?

Palliative Care Medications

Rigor Mortis

Flail Chest Management

Defib Pad Placement

Trauma VSA Transport Times

Posterior STEMI Bypass

MAP vs. BP

SET Protocol

Rounding Medication Doses

Palliative Care Medications

PCP AIV Ondansetron Administration

Pediatric Airway Equipment Dead Space

Appropriate BP Site

Intranasal Dexamethasone

Postural Vital Signs

STEMI + and Transport to PCI Timeline

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Paramedic Practice

Pediatric Nasal Suctioning

ICD Deactivation

STEMI contiguous leads

Topping Up Patient Medications

Intervening on a flight

Disclosing Information

Heated blankets for hypothermic/trauma patients

Do we need to reassess patients in an MCI?

Palliative Care Medications

Rigor Mortis

Flail Chest Management

Defib Pad Placement

Trauma VSA Transport Times

Posterior STEMI Bypass

MAP vs. BP

SET Protocol

Rounding Medication Doses

Palliative Care Medications

PCP AIV Ondansetron Administration

Pediatric Airway Equipment Dead Space

Appropriate BP Site

Intranasal Dexamethasone

Postural Vital Signs

STEMI + and Transport to PCI Timeline