Date Published

February 4, 2020

Updated For

ALS PCS Version ALS PCS Version 5.2


My question comes from the Medical Cardiac Arrest Directive and specifically in relation to the clinical considerations section. I have two questions relating to this.

First of all, the medical directive lists medication overdose/toxicology as a circumstance where the paramedic can consider very early transport after the 1st analysis. My question is can this also apply to overdoses from recreational drugs? It touches on cardiac arrest with associated opioid overdose but doesn't go into great detail besides the role of naloxone in these circumstances.

Secondly, it lists pediatric cardiac arrest as a situation where we the paramedics are to plan for extrication and transport after 3 analysis. However due to the rarity of this circumstance and the likelihood of its origin resulting from a reversible cause would the paramedic be correct in transporting these patients immediately following the 1st analysis?


Thank you for your question and thoughtful deep-dive into the Medical Cardiac Arrest Directive:

Early transport should be considered in an arrest from suspected overdose (recreational OR pharmacologic) so long as the patient is not obviously dead, as per the Deceased Patient Standard.

Please see the Ask MAC from 11-Aug-2017 where this pediatric consideration was posed and answered.



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