Hi MAC, hope you folks are well. I was curious if you can provide clarification and potentially rational to the "Mandatory Patch Point" for Medical Cardiac Arrests. Although I understand calling for termination or potentially further direction, I am curious if we have to BHP patch if the attending Paramedic feels the Pt in cardiac arrest [that fits criteria for TOR] would benefit from transportation for any variety of situations (age, geo. location, ect.). It seems it would be counter-intuitive to spend the time calling an MD to tell them we feel transport would be beneficial for a Pt (especially if ready to transport) instead of initiating time critical transport + our active resuscitation efforts. Would a BHP ever say no, do not transport this Pt, regardless of potential ED Tx benefit? I recognize this is an odd question that is a rarity, but I've found myself in this position more than once and am wondering how to efficiently tackle these situations in the future without a potential protocol violation. Cheers MAC. 

The Mandatory Provincial Patch Points are required when there are high risk decisions to be made that would benefit from BHP consultation. When calling the BHP for a Medical TOR, it is best to describe to the BHP why you think that further treatment for this patient isn’t futile and why the patient would benefit from being transported to hospital. During the auditing of BHP patches, we have seen several instances when paramedics are calling to transport a medical cardiac arrest patient but the discussion between the BHP and paramedic results in a mutually agreed upon decision to TOR after the consultation. The patch point is put in place for consultation for treatment. Just because a patient meets the TOR criteria (or any criteria for BHP patch) does not mean that this treatment will or should be granted.  

Cardiac/Circulation,Medical Cardiac Arrest,Trauma Cardiac Arrest

BHP Patch, Mandatory Provincial Patch Point, Medical TOR, Orders

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