Base Hospital is pleased to offer a Question & Answer forum for paramedics. To submit a question, please fill in the form below. Check back here in a few days for a response. Your name will not be published.

Q: I am looking for some clarification on giving ventolin to a patient with suspected pneumonia ... is this contraindicated?

A: A paramedic may administer Salbutamol to any patient with a complaint of SOB or exhibiting respiratory distress not thought to be related to acute cardiogenic pulmonary edema. The medical directive does not indicate pneumonia is a contraindication for Salbutamol. It does indicate that the patient must have evidence of broncho constriction or wheezing.The rational for this is that patients can have more than one pulmonary disease going on at the same time. For example, they may have underlying asthma or \COPD, both of which could be exacerbated by the pneumonia. Therefore, MDI administration of Salbutamol is not contraindicated for pneumonia.

Keep in mind, any patient with a fever of greater than or equal to 38 degrees Celsius cannot receive Salbutamol by nebulization.

(date posted: 04/12/08)

Q: During an IM injection, if you aspirate with the syringe, and hit a vessel what do you do:

1) start all over with a new med and syringe
2) or relocate the syringe in a new area

A: Firstly, let me clarify that the correct procedure for IM injection includes aspirating with the syringe to be sure you will not inject the medication directly into a blood vessel. If you should aspirate and hit a blood vessel, you must start the procedure from the beginning - use a new alcohol swab to clean the injection site, use a new syringe and a new needle and you will need to draw up new medication. Don't forget to document all of your IM attempts,successful or otherwise, onto your ACR.

(date posted: 14/10/08)

Q: I have heard rumours that there will soon be research initiatives undertaken in Thunder Bay, can you clarify this? How will it affect my practice as a paramedic?

A: Yes it is true. We have decided to take part in pre-hospital research initiatives under the guidance of the newly formed Ottawa Health Research Institute (OHRI). There are two studies presently being looked at, the Hypertonic Saline Study and a CPR Study. As a Paramedic involved in the research study, we will expect that as patients are assessed in the field to meet the criteria of the study, strict procedures will be followed; very specific patient care will be required and accurate documentation will be paramount. We expect that our first research study will commence in early 2006.

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