Question: In regards to cardiac arrest secondary to drug overdose. A VSA in an instance where Cocaine and or Meth have been used in excess causing death. Would this fall under unusual circumstances and therefore be transported or would it follow a medical TOR and require a patch to base hospital?
This is a great question and we can see where the confusion arises. The SWORBHP Medical Council has decided that in order to make it easier for paramedics, they not have to decide on the spot if an arrest was of suspected cardiac etiology or not to patch to the BHP for consideration of a TOR. Click here to see question #2 posted on Feb 6, 2012 with the rationale for this decision.
This was meant to include drownings or asphyxial type of cardiac arrests which have caused confusion in the past.
The Medical Cardiac Arrest Medical Directive however specifically mentions that:
In unusual circumstances (e.g. Pediatric patients or toxicologic overdoses), consider transportation following the first rhythm analysis that does not result in a defibrillation being delivered."
So to answer your question, the SWORBHP would suggest that, as per the Medical Directive, in the case of a suspected arrest due to a toxicologic overdose, the paramedic consider transportation following the first rhythm analysis that does not result in a defibrillation being delivered.