AskMED 2017 (5) - November 21, 2017
Questions answered in this AskMED session
1:50 - I was watching an archived episode of AskMED (May 10, 2016) and there was discussion regarding treatment of the hypothermic cardiac arrest patient.I was watching an archived episode of AskMED (May 10, 2016) and there was discussion regarding treatment of the hypothermic cardiac arrest patient.During the video, both Dr. Lin (@26:20) and Dr. Welsford (@27:55) made reference to treating the patient with an initial round of medication prior to transport. I was always under the impression that NO medications are to be administered to the hypothermic cardiac arrest patient. I looked back in the last 3 editions of our directive books and I can not find any mention of medication given to hypothermic cardiac arrest patients.Could you please clarify?
5:50 - Should Epi and/or Benadryl be given to a patient experiencing a swollen tongue due to ace inhibitor reaction/long term use?
9:37 - What is CPER's stance on hospital staff initiating an IV and administering Gravol (or Zofran) to a pt who is c/o nausea/vomiting, otherwise stable, who is on offload delay with a PCP crew? (who is not certified to perform this directive) If allowed, are there any other medications that would be appropriate for hospital staff to administer to a pt under PCP care while on offload delay?
14:17 - With regards to the adult analgesia medical directive, what type of renal colic history does a patient need to receive analgesics by paramedics? Specifically, does the patient need previously diagnosed renal colic/kidney stones and be in the same type of pain as before? What if the patient has a hx of renal colic but is experiencing a different type of pain as before e.g patient before had back pain but today has lower abdominal pain? Thanks!
17:39 - When do we honour an Office of the Fire Marshall DNR? when the patient is in cardiac/ respiratory arrest or prior to? Some of the procedures such as "use of opiod antagoinst" and "transcutaneous pacing" would not apply to a cardiac arrest situation.
22:48 - My question relates to a multiple patient trauma situation where you are the only crew on scene or where resources are otherwise overwhelmed with deceased patients and critical patients. Is there an expectation to obtain TOR or undergo resuscitation efforts for deceased patients when there are living patients that would benefit more from your treatment? This question is specific to patients that do not meet obvious death criteria but are VSA. I am concerned with the time calling for BHP and resources spent on a non-salvageable patient where prompt treatment of a critical patient could have significant benefit. There is no specific direction in the directives but MCI principles is mentioned in the BLS PCS. My question relates to a multiple patient trauma situation where you are the only crew on scene or where resources are otherwise overwhelmed with deceased patients and critical patients. Is there an expectation to obtain TOR or undergo resuscitation efforts for deceased patients when there are living patients that would benefit more from your treatment? This question is specific to patients that do not meet obvious death criteria but are VSA. I am concerned with the time calling for BHP and resources spent on a non-salvageable patient where prompt treatment of a critical patient could have significant benefit. There is no specific direction in the directives but MCI principles is mentioned in the BLS PCS.
