Part 1 - Questions answered in this AskMED session
1:37 - What are your thoughts towards patching for patients presenting from etoh withdrawal for fluid and possiblly a small dose of midazolam?
5:47 - Regarding the new D10 protocol. Dose administration for a adult above 50 kg is the max single dose of 10g (100ml). While administering with the the buritrol for accuracy if the patient begins to respond and comes back to GCS 15 after only part of that dose for arguments sake 70 mls. Do we stop infusion of the rest of the 30 mls or 3g of Dextrose and encourage them to eat some carbohydrates or anything they have at home or do we finish the dose of D10 all the way. Only ask because now administering the new D10 could take 5-10 minutes where as before we were just dealing with a quick push of D50?
8:02 - For medical VSA. First 4 analyses non shocks (2 asystole and 2 pea). TOR is gotten but as partner is on the phone a rhythm change is noted into. Vatch. We are now past the 4 analyses in the ALS but have a new shockable rhythm. Can we now re start are protocl due to the new rhythm change?
9:37 - In areas outside of Ontario it is not uncommon to find medical directives for paramedics to treat hemodynamically stable patients with new onset rapid a-fib chemically for rate control. The most common I have seen is one of the calcium channel blockers IV. Do you see this as a treatment option which may become available in Ontario?
11:33 - Transfer of Care
15:31 - I was just wondering if we are looking at other options for analgesia for PCPs. I hear that some provinces are using entonox with success, and that BC is conducting a ketamine trial for PCPs. Just wondering what the chances of us doing something similar are.
18:00 - Is it appropriate to call BHP for orders for sedation prior to intubation?
Part 2 - Questions answered in this AskMED session
0:16 - Rapid sequence intubation discussion (continued)
1:36 - Pt on anti-coagulant therapy is a contraindication for ibuprofen and ketorolac. My question pertains to Plavixx, will it also be contraindicated. The protocol speaks specifically to anti-coagulants?
2:22 - In the updated cardiac ischemia protocol, ACP's can administer 2mg q5mins of morphine after the 3rd dose of NTG if pain level is still 7/10 or greater. If NTG is contraindicated or max dose reached and you have administered a dose of morphine and your reassessing for a second dose. If the pain is lower then a 7/10 but still evident and distressing the patient. Are we to stop administration of 2mg q5 minutes of morphine if pain is bellow 7/10 or continue till pain is zero or just tolerable?
4:30 - Discussion of Paramedic 2 trail (epinephrine study in out of hospital cardiac arrest)
9:58 - If a dialysis pt is showing signs of stroke and is in the window, Can they be transported to HGH ?
10:58 - just wondering if you could provide some information on the term secondary drowning. Also, what is the time span for these S/S to present? Lastly, what would hospital intervention for pulmonary edema due to near drowning include?
13:18 - There has been a few instances where a paramedic may patch for orders for a Patient, then have to transfer that pt to another crew with equal level of care. i.e. at an MVC or more likely a crew taking over during Offload delay. Can that order be passed on? I fell like it might cause trouble but it would be the easier option.
15:13 - Ketamine for Excited Delirium / Fentanyl (discussion)