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Neonatal Resuscitation Question: Persistent Heart Rate Around 80 bpm Despite Effective Ventilation
In neonatal resuscitation, it seems possible to get stuck in a decision loop, and I am wondering whether NRP offers any explicit guidance for this scenario.Consider a freshly delivered neonate who is breathing but has a persistent heart rate of approximately 80 bpm. The infant is receiving oxygenated positive-pressure ventilation, which appears effective, yet there is no improvement in heart rate after repeated 30-second reassessments. The infant continues to appear clinically unwell.Following the algorithm strictly, progression to chest compressions does not occur because the heart rate remains above 60 bpm. However, 80 bpm is clearly abnormal for a term newborn, and after several ventilation cycles it can feel uncomfortable to continue without escalation. My instinct in this situation would be to consider starting compressions, particularly if the overall clinical picture is deteriorating.Does NRP provide any guidance for exiting this loop, or is management primarily based on the global clinical picture and provider judgment?
Should additional Diphenhydramine be provided if a patient took a smaller dose than in the directive?
In the case of a moderate to severe allergic reaction, where epi and 25mg of diphenhydramine have already been administered, are we permitted to administer another full 50mg of diphenhydramine, or should we just top up the dose and administer a additional 25mg to make a total of 50mg for the patient.
Can Bimanual Compression be Delegated?
In the event of a postpartum hemorrhage is external bimanual compression something that can be delegated to allied resources on scene (ex. FD) if the paramedic has other tasks to attend to? Or since it is listed a delegated medical act is it something only a certified paramedic can do?
ASA for ACS When the Patient has History of ACS?
A patient with a history of AAA repair two years ago presents with severe lower abdominal pain and concurrent chest pain with cardiac features. Vital signs show hypertension with equal bilateral pressures. In this situation, is ASA still appropriate for suspected ACS, or should it be withheld due to concern for a possible AAA related complication?
Can midazolam be administered to treat a dysphoric reaction to an analgesic dose of ketamine?
Can midazolam be administered to treat a dysphoric reaction to an analgesic dose of ketamine?