Question: For teaching purposes. While assessing a patient, how important is it to determine any and all treatments or interventions provided to the patient by allied agencies, bystanders, self-administration or other medical professionals prior to the arrival of the Paramedics? How important is it to determine an accurate time line of those treatments or interventions? Is oxygen a treatment and/or intervention?

We can certainly appreciate the fact that not all information may be made available to you at the time of your patient assessment. That being said, it is important to gather as much information as is reasonable when doing a patient assessment. The rationale behind this is that the patient may have received a treatment from family or a bystander that might be a contraindication for a potential treatment that you, as the paramedic, might otherwise administer. As well, when there is a patient in front of you that you are assessing, their presentation is a product of whatever illness is affecting them at that time as well as treatments that have been provided prior to your arrival.

Oxygen most certainly is a treatment, and is governed by the Basic Life Support Patient Care Standards (BLS-PCS). Oxygen, when not indicated, can actually result in patient harm. For example, there is literature available now regarding potential harm associated with the application of supplemental oxygen in MI patients who already have normal saturations, as a result of hyperoxia.

Also, your ACR contains a wealth of information that can be utilized for prehospital research in order to further develop evidenced based prehospital care. The pre arrival interventions are variables that are often looked at in research studies so the more accurate and complete the documentation, the more precise a research question can be answered.

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