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.
The Medical Cardiac Arrest Directive, ROSC Medical Directive, Cardiogenic Shock Medical Directive, IV Fluid Therapy Medical Directive, Symptomatic Bradycardia Medical Directive (notes section) all include allowances for fluid boluses in certain conditions. The details are clearly listed in each directive and also addressed by other FAQ posted on this website. This is not an exhaustive list. It is the responsibility of each paramedic to be familiar with the Advanced Life Support Patient Care Standards that form your scope of practice. Fluid boluses (when a paramedic is IV certified) where described in these standards form an essential element of that scope