MedicASK Recent Answers

I had a question about treating a patient after we 10-7 at the hospital. If we are waiting to be triaged or on off load delay, can we start a new treatment (ie. for nausea/vomiting) if we have already 10-7 at the hospital? There are mixed opinions about this and just want some clarity.

Is an ACP authorized to provide opiate based analgesia to a patient in the care of a PCP crew after their arrival to the ED? For example, if a PCP crew brings a patient in Sickle Cell crisis to the ED, and there is a prolonged period of time before they are able to triage and offload, can an ACP that is present in the ED assume care for that patient, establish an IV and administer Fentanyl; provided that they are added to the PCR and remain with the patient until they are offloaded to the ED and a report is given to the receiving staff?

Can you administer analgesia for headache?

Should a patient with mast cell activation syndrome be treated the same way as a patient experiencing an allergic reaction or anaphylaxis?I recently attended a patient with known mast cell activation syndrome following a motor vehicle collision with a deer. While we were responding, we were advised that the patient had already used two epinephrine auto-injectors.On arrival, the patient was in respiratory distress and reported feeling unable to breathe. She could speak only briefly because talking appeared to worsen throat irritation and the sensation that her airway was closing. Her lung sounds were clear but diminished because she was unable to take a deep breath. Her oxygen saturation was 98%, and she was tachycardic and hypertensive.The patient’s family stated that stress can trigger her mast cell activation syndrome and that she usually requires additional epinephrine. Following consultation with a base hospital physician, diphenhydramine was authorized, with further epinephrine to be given if the patient’s condition deteriorated.In a similar situation, should the patient be treated directly under the anaphylaxis directive, or is a patch required because the episode was triggered by stress rather than exposure to a known or suspected allergen?

In conversation with colleagues, I have been getting mixed opinions with applying CPAP to a pt with a DNR. Some see it as artificial ventilation other see it as treatment. Inwould love to hear base hospitals perspective on this.