Question: You have a patient who you obtain ROSC and return of spontaneous respiration on scene who was in a VF (post rosc 12lead shows STEMI). They arrest on route into a VF, we pull over, defibrillate. You resume transport and reassess after each cycle of CPR. If you obtain ROSC again during transport, and the patient rearrests for a second time, is it prudent to pause transport quickly again for defibrillation. The treatment for VF is defibrillation. If there is still prolonged transport the pt will likely deteriorate to asystole if not defibrillated, correct? I appreciate we do not want to delay definitive care, would it be helpful or harmful to continue defibrillation in this setting.

Question: In the Symptomatic Bradycardia Medical Directive, both atropine administration and TCP have hypothermia listed in the contraindications. However, this contraindication is not present for dopamine administration.

This seems to contradict the practice of not giving drugs to the severely hypothermic patient and focusing prehospital care on rapid transport and passive rewarming. Was this omission voluntary and if so, what is the rationale or the studies that support the use of dopamine in such a case? Thank you!

PS: Hypothermia is not listed as a contraindication for dopamine in the ROSC protocol either.

Question: In regards to the base hospital recertification for 2014-2015, in the video for medical cardiac arrest the paramedic received a ROSC and was re-evaluating vitals q1 minutes, however, in the quiz it was noted that you are to re-evaluated vitals q3-5 minutes. Can you please clarify?

Question: Would bolusing a hypothermic ROSC be considered active rewarming?