AskMED February 21, 2023

0:00 Introduction
0:34 Analgesia and Labour
3:00 ASA and dysrhythmias
6:40 Updates to Medical Cardiac Arrest Directive
11:10 Sickle Cell Anemia with chest and back pain
21:10 Nitroglycerin and right-sided MI
25:30 Valsalva in PCP scope
Analgesia and Labour - The analgesia directive says no morphine or fentanyl for patients in active labour, that we know. Would the abdominal cramping that comes with a miscarriage, abortion, known fetal death; would that cramping also be considered "active labour" for the purposes of this directive?
ASA and dysrhythmias - Recently had a unstable patient, presented with a narrow complex irregular tachycardia. Because the patient was unstable, I was given order for cardio version and it worked. The post-cardioversion 12-lead showed some ST-depression, but, I figured I had solved the problem by cardioverting the patient. If i was worried about the possibility of ongoing ischemia, should I consider giving ASA, would it be beneficial?
Updates to the medical cardiac arrest directive - Regarding changes to medical cardiac arrest directives (ALC PCS 5.1), if we have a ROSC patient, and they re-arrest during transport to hospital. Are we doing one analysis and continuing to the hospital or are we completing 20 - minutes of resuscitation efforts?
Sickle Cell Anemia with chest and back pain - 36 year old female with a history of sickle cell anemia, who comes in with chest and low back pain. Pain is described as sharp and squeezing, they have hydromorphone for their history of vasoocclusive crisis, they have taken it and pain is getting worse. What directive to use to take care of patient?
Nitroglycerin and right-sided MI - Paramedic student, writing a research paper on the contraindication of nitroglycerin on right ventricluar MI. What is the current evidence used to support that contraindication? Is it the Ferguson et al. study in 1989 or is there more recent evidence to support the contraindication?
Valsalva in PCP scope - why isnt valsalva included in the primary scope?