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Welcome to MedicASK. This section of the NWRPCP website provides paramedics the opportunity to ask questions to our Medical Directors regarding ALS PCS medical directives or other related patient care opportunities.

All questions will be reviewed and answered by staff within the NWRPCP. Please browse through our questions and answers, as well as the latest ALS or BLS Patient Care Standards or Companion Document for the Advanced Life Support Patient Care Standards.

MedicASK questions that have been answered by the NWRPCP are posted below.

If you are unable to find your specific topic please complete the new question form.

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MedicASK Answers

Vector change with pad placement

16 December 2020
Submission ID: 25 Question: Would it be acceptable to attempt anterior/posterior pad placement if 3 attempts of the anterior/apex placement does not work? Would we have to patch for this? I would of course just use a new set of pads and keep the originals on, and only attempt if it could be...

Resuscitation with signs of obvious death

18 September 2020
Submission ID: 23 Question:  Can you please provide direction on what would be the most appropriate action for situations involving the initiation of cardiopulmonary resuscitation by first responders, prior to Paramedic arrival, who is then deemed to meet the obvious death criteria under t...

Nitro patch removal

18 September 2020
Submission ID: 22 Question:  Hi there, I would like to inquire about whether or not there is a need to remove a patient’s Nitroglycerin transdermal patch prior to delivering Nitroglycerin SL under the Cardiac Ischemia or Acute Cardiogenic Pulmonary Edema Medical Directives. Much appreciate...

Clarification on oxygen delivery for COVID-19 Patient

13 April 2020
Submission ID: 19 Question:  I just have a question in regards to oxygen treatment. With the recent memorandum it states that in all cases high flow oxygen delivery should be avoided unless via ETT/SGA. Does this mean we are no longer able to use a BVM for a patient who is severely short o...

Clarification on COVID-19 memorandum on Treatment Considerations

23 March 2020
Submission ID: 17 Question:  As per the new amendments that came out today are we with-holding CPAP (in all cases) including those who screen negative for COVID-19 assuming that they could still be a positive case? Some clarification is required. Answer: Thank you for your question r...

BHP Webinar

07 February 2020
Submission ID: 16 Question:   On a recent webinar Dr. Exley cited two examples of orders a BHP might give that should not be followed because they are out of the scope of practice. One was an ACP getting an order for Atropine for a cholinergic overdose. My question is just to clarify thi...


12 July 2018
Submission ID: 4 Question:   Just have a question about ASA in regards to administering the drug for new onset cardiac ischemic rhythms. An example would be a patient in 2nd degree type 2 heart block with no other cardiac ischemia signs/symptoms but has no history of a heart block before ...

Analgesia Medical Directive Question

26 June 2018
Submission ID: 1 Question:   This question is regarding the indication for the new analgesia medical direction. The new indication is just "pain" with a contraindication of suspected cardiac ischemia. I am aware of plenty of situations where this protocol would be appropriate. Example a f...