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Under the nitroglycerin contraindications it notes phosphdiesterase inhibitors. In the companion document it references PDE5s, but I do not recall reading that other forms are disclosed from the definition. What about PDE-4 inhibitors?

What is your opinion on treatment of suspected pseudo seizures? Is there any negative outcome from treating with Midazolam? Additionally, how would you recommend we identify these types of seizures and document our reasoning to not treat them if we choose that route?

While reviewing Newborn Resus vs Pediatric VSA I noticed the concentration for epinephrine are different for ETT. I am just curious as to why we use 1:1000 for the pediatric VSA but 1:10000 for the newborn resus.

I have a question about the contraindication in the Analgesia Medical Directive that lists “suspected ischemic chest pain.” My understanding has always been that this meant we should not administer analgesia for ischemic chest pain itself, except for morphine under the Cardiac Ischemia directive. However, if another pain source, such as a headache, occurred alongside suspected ischemia, I thought we could treat that secondary pain with something like acetaminophen.After reviewing some recent discussions and material from other Base Hospital Physicians, I am beginning to wonder if that interpretation is correct. Does the presence of suspected ischemic chest pain act as an absolute contraindication to all analgesia outside of the Cardiac Ischemia directive, or can we still manage unrelated pain once appropriate treatment for ischemia has been initiated?Lastly, if we have administered 160 mg of ASA, does that contraindicate the use of an NSAID due to overlap or interaction?

In medical cardiac arrest cases where a potentially reversible cause cannot be corrected in the field, such as hypothermia, mixed overdose, pregnancy, or a remaining foreign body airway obstruction, should Paramedics continue rhythm analysis every two minutes once transport is prioritized and initiated, or should only one analysis be performed prior to departure similar to a traumatic cardiac arrest?