policy and procedure quiz

8.2

intercept may be needed for patients who

• unexpectedly become unstable during transfer

• being transported from field to higher level of service

• condition needs higher level of care or additional resources

specific cases for intercept

• undergoing CPR

• in respiratory distress

• hypotensive

• uncontrolled chest pain cardiac origin

• grand mal seizures longer than 15 minutes or without regain of consciousness between seizures

• decreased LOC where hypoglycaemia or narcotic overdose is not ruled out

• arrhythmia unless known to be benign

• childbirth

options after intercept for higher training member

• transfer patient to own unit for transport and referring member accompanies

• accompany patient in referring unit

• return to unit and allow referring unit to complete transport after no further interventions needed

destination and bypass guidelines

• all health care facilities must carry out inventory of facility

  • human resources

  • beds

  • etc.

• health care facilities and EMS must have agreement regarding destination and bypass

if during destination and bypass patient is worse than thought

• contact physician to arrange rerouting

• if not available go to nearest health care facility

• if physician refuses proceed to prearranged facility and document

what conditions should be transported rapidly

• airway obstruction

• cardiorespiratory arrest (acp)

• shock or anything that will result in shock

• head injury with

  • unconsciousness

  • decreasing LOC

  • penetration to head

• respiratory distress that is not relieved by. oxygen

• seizure longer than 15 minutes or without regain of consciousness between seizures

load and go secondary assessment is done when?

during transport as long as it doesn’t interfere with ABCs

what to do for conflict between health care providers

contact a physician

conflict where no physician is available

• patient is first priority

• nothing outside of scope

• highest level of training is responsible

• document disagreement and resolution '

• PCR and other documents sent to SHA medical advisor

• refuse if believe to be not in the best interest of patient

pulse oximetry minimum level

• greater than 95 percent

• except patient with COPD

what to do if SPO2 drops despite maximum oxygen

ventilate patient

SPO2 readings may not be obtained in which circumstances

• severe peripheral vascular disease

• use of vasoconstrictors

• hypothermia

• hypotension

• placement distal to a tourniquet or blood pressure cuff

when to use pulse oximetry

• respiratory distress

• critically ill patients

• requiring O2 40 percent or higher

• stable but risk of deterioration

• monitoring during procedures like suctioning or intubation

• systolic blood pressure

standard approach

• primary survey

  • identify life threatening conditions

• secondary survey

  • detailed history and vitals, physical examination

primary survey

• scene safety

• LOC AVPU

• ABCs

secondary survey

• history

• vitals

• physical examination

when to measure glucose

• seizure

• sick pediatric patients

• decreased LOC

• syncope

• abnormal behaviour

• suspected hypoglycemic

glucose monitoring distortion

• blood volume on sensor

• oxygen level of blood

• glucose contaminants on skin

when transporting patient with medical device in place

• ensure approved to manage

• must be hemodynamically stable

• check vitals every 15 minutes

• go to nearest medical facility of patient develops effects

• patient should be able to care for device