Advanced Life Support Patient Care Standards Version 5.4 Flashcards

General terminology, clinical definitions, and standard vital sign thresholds from the Advanced Life Support Patient Care Standards (ALS PCS) Version 5.4.

Authorization

Written approval to perform Controlled Acts and other advanced medical procedures requiring medical oversight of a Medical Director.

Certification

The process by which Paramedics receive Authorization from a Medical Director to perform Controlled Acts and other advanced medical procedures in accordance with the ALS PCS.

Consolidation

A process restricting a Paramedic's practice to working with another Paramedic with the same or higher level of qualification; minimum duration is $36\text{ hours}$ for a PCP and $168\text{ hours}$ for an ACP or CCP.

Controlled Act

A Controlled Act as set out in subsection 27(2) of the Regulated Health Professions Act, 1991.

Critical Omission or Commission

The performance of a Controlled Act or procedure that a Paramedic is not authorized to perform, or an action/lack of action that has negatively affected or has the potential to negatively affect patient morbidity or mortality with a life, limb, or function threatening outcome.

Major Omission or Commission

An action or lack of action by the Paramedic that has negatively affected or has the potential to negatively affect patient morbidity without a potentially life, limb or function threatening outcome.

Minor Omission or Commission

An action or lack of action that may have negatively affected patient care by causing delays or lengthening recovery, but has not negatively affected patient morbidity.

Deactivation

The temporary revocation, by the Medical Director, of a Paramedic's Certification.

Decertification

The revocation, by the Medical Director, of a Paramedic's Certification.

PCP Assist IV

Authorization for a PCP to cannulate a peripheral IV at the request and under the direct supervision of an ACP; the PCP is not authorized to administer IV therapy.

PCP Autonomous IV

Authorization for a PCP to independently cannulate an IV and administer IV therapy according to applicable Medical Directives.

Home Medical Technology

An external or internal mechanical device prescribed by a member of a regulated health profession for the purpose of treating a medical condition.

Novel Medication

A self/caregiver-administered medication prescribed for rare and unusually complex chronic medical conditions, often end stage.

Consider

A convention indicating that a paramedic shall initiate treatment when the indications are first identified unless there is strong clinical rationale to withhold or delay.

Normotension (Adult)

$$SBP \text{ (Systolic Blood Pressure)} \geq 100\,mmHg$$

Hypotension (Adult)

$$SBP \text{ (Systolic Blood Pressure)} < 90\,mmHg$$

Bradycardia (Adult)

$$HR \text{ (Heart Rate)} < 50\,BPM$$

Tachycardia (Adult)

$$HR \text{ (Heart Rate)} \geq 100\,BPM$$

Tachypnea (Adult)

$$RR \text{ (Respiratory Rate)} \geq 28\,\text{breaths/min}$$

Normotension (Pediatric)

$$SBP \geq 90\,mmHg + (2 \times \text{age in years})$$

Hypotension (Pediatric)

$$SBP < 70\,mmHg + (2 \times \text{age in years})$$

Weight Calculation (Pediatric)

$$\text{Weight (kg)} = (\text{age} \times 2) + 10$$

Hypoglycemia (Age < 2 years)

$$\text{Blood glucose level} < 3.0\,mmol/L$$

Hypoglycemia (Age \geq 2 years)

$$\text{Blood glucose level} < 4.0\,mmol/L$$

Altered (LOA)

Refers to a Glasgow Coma Scale (GCS) that is less than normal for the patient.

Unaltered (LOA)

Refers to a Glasgow Coma Scale (GCS) that is normal for the patient, which may be a $GCS < 15$.

Refractory VF or pulseless VT

Persistent VF or pulseless VT after 3 consecutive shocks.

Medical TOR (Rule Conditions)

Arrest not witnessed by paramedic AND no ROSC after $20\text{ minutes}$ of resuscitation AND no defibrillation delivered; applies to patients age $\geq 16\text{ years}$.

Trauma TOR (Rule Conditions)

Age $\geq 16$, no palpable pulses, no defibrillation, and rhythm is Asystole (or PEA with ED $\geq 30\text{ min}$ away), with no signs of life after extrication.

ALARM

A maneuver for shoulder dystocia during emergency childbirth; should be performed twice on scene.

Mauriceau Smellie-Veit maneuver

A maneuver attempted during breech delivery once the hairline is visible and/or $3\text{ minutes}$ have passed since the umbilicus was visualized.

COWS (Clinical Opiate Withdrawal Scale)

A scale where a score $\geq 8$ is an indication for buprenorphine/naloxone administration.

DSED

Double Sequential External Defibrillation.

VCD

Vector Change Defibrillation.

Primary confirmation method for Advanced Airways

$$ETCO_2 \text{ (Waveform capnography)}$$