Question: This is in regard to the Medical TOR protocol. If we’ve reached the mandatory patch point at three consecutive non-shockable analyses (and made the call to the BHP) and there is any sort of delay (meaning we’ve reached the fourth analysis), do we then transport? People are getting confused because some heard that they were to keep analyzing while they waited for the BHP to come on the line. That’s not how I perceived it. Regardless of any delay at any time, the protocol states that we only analyze a total of four times (unless you are an ERU) followed by CPR for the duration of the call, correct? People hear different things, and I just want clarification so that we can all be on the same page. Thanks

Question: If a patient is between ages 8-12 and is VSA, are we still using the lowest Joule setting?

Question: If you get a ROSC on scene, after one analyze, patient rearrests enroute, can we pull over and finish the protocol? One analyze or three?

Question: Since we’re now able to administer Epi for VSA Anaphylaxis, why are we not able to do so for Severe Asthma VSA?

Question: In the December 11, 2011 powerpoint on Termination of Resuscitation. The slide on page 37 states the Medical TOR applies to all medical VSA that are cardiac in nature and asphyxial in origin including hanging, drowning electrocution. The webinar from our recerts states Arrest thought to be non cardiac in origin, i.e. OD, Trauma, Hanging, Drowning are a contraindication to the TOR. Could you please clarify?

Question: I was just wondering in case Im asked by the Police Department… in a medical TOR, what physician signs the death certificate?

Question: In our recert course, we were told that ACPs must patch to the BHP after the third analysis (during a medical arrest). Why do we have to patch so early? Shouldn’t we patch after three rounds of epi?

Question: In regards to the new medical VSA directive: Would CO poisoning leading to VSA be considered an unusual circumstance? Thus performing one analysis and transporting would be acceptable?

Question: I see that it says consider NaCl bolus in the cardiac arrest standing order. In the past we gave a bolus for PEA as well as Rosc’s. Can you confirm the exact circumstances we are to give the bolus as I find there to be a lot of gray areas in our orders.

Question: The PCP Medical TOR says that I can “move the patient to the ambulance prior to initiating the TOR if family is not coping well or the arrest occurred in a public place”. What is an example of a public place? and if I move them to the ambulance and then get the TOR, is this now the place of death and I have to wait for the coroner to arrive?