is there any consideration(s) to move away from the ” double syringe method” to a single syringe method for adenosine ?? – using 20 ml or larger syringe meaning adenosine mixed with ns and then pushed as 1 dose – medication and flush ?? various studies have shown that is effective, less operational stressors , and easier to manage then attempting use a stop cock valve, ns line wide open with flushes, etc

Hello, some further clarity/confirmations on the trauma cardiac arrest algorithm is still needed for a rather large group of paramedic students. Note, some of the “greater/less than” symbols in your previous replies show up as papyrus-esque and cannot be deciphered. Please reply with words only in case that issue repeats itself. -A patient with penetrating trauma to head/neck/torso in asystole (and no signs of life): if nearest LTH is greater than 30 min away, but nearest regular ED is 15 min away, we still patch for trauma TOR, right? Or do we transport to that nearest regular ED? -A patient with penetrating trauma to head/neck/torso in PEA: if nearest LTH is greater than 30 min away, but nearest regular ED is 15 min away, do we patch for trauma TOR (due to over 30 min transport time to LTH) or do we transport to that nearest regular ED that’s 15 min away? -A patient with a blunt trauma and asystole (and no signs of life) automatically gets a patch for TOR, right? -A patient with blunt trauma in PEA would only get a patch for TOR if there was no hospital (regular ED or LTH) that was less than 30 minutes away? Ie. Only patch for TOR if either ED or LTH were both over 30 minutes away. Thanks!

As a PCP I am trying to get a better understanding of what orders a BHP can give and when certain orders may be considered outside our scope of practice. My understanding has always been that deviations can be made to most areas of a protocol like age, RR, SBP, LOA, contraindications, dosing levels, # of doses etc., but what about treating conditions or diseases that are not written into the protocol? ex. Tylenol for fever, Glucagon for beta blocker toxicity, energy for SVT or Ventolin for hyperkalemia? Although we are trained in how to use these drugs are we expected to give them for conditions not listed in our protocol, if ordered by a BHP? Thanks

What is considered suspected cardiac ischemia? Is it just the presence of chest pain/ discomfort (heaviness or tightness). Are chest palpitations considered a chest discomfort as well?

Can I attempt the Valsalva on a patient who has chest pain? What if the patient has a clear onset of palpitations, then after onset develops chest pain and or shortness of breath?

hello when treating a pt with adenosine the contra indications are active bronchial constriction on exam, the companion document also states that adenosine can cause bronchial constriction in asthmatic pts. so may question is … is an asthmatic pt contraindicated for adenosine tx or is more of a relative vs absolute situation

Given that rapid atrial fibrillation and other tachydysrhythmias can result from myocardial ischemia; is it wise to provide ASA to these patients as a precaution. I am a PCP, and we dont have a defined treatment for pulsed tachycardia.