Question: I have recently came across a situation where an ACP/PCP crew decided to have the non-IV cert PCP attend a Stroke Protocol call, and the ACP replied that he/she did not think it was necessary. Because the protocol requests a IV be established whenever possible, should the ACP have attempted an IV and attended?
Excellent question. The decision as to when to attend when in an ACP/PCP crew configuration can be contentious. Our policy and procedure manual states that the ACP MUST attend any patient when the patient has received, requires, or is anticipated to require an intervention or treatment beyond the PCP scope of practice.
In reviewing the paramedic prompt card for acute stroke protocol, we do not see where it is stated that an IV be established whenever possible. However, acute stroke patients are unwell patients and seizures are more likely to occur than in other patient populations (ACP management Medical Directive). Moreover, there are a myriad of stroke mimicking diagnoses that are also have the potential for a patient to clinically deteriorate during the transport phase therefore an IV being established and having the ACP attend is a reasonable management plan.