MJM Medical Direction Consortium Services
Our Mission: To provide EMS medical direction, continuing education, and patient care related skills development to promote a consistent and progressive model of prehospital patient care throughout Greater Minnesota
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FAQ Question of the Week
Say we get a call and we are doing active CPR on our patient. A family member later(after we already started CPR) comes and provides us with a valid POLST document. Do we then stop CPR or do we continue until a higher level of care arrives and they make the decision to stop?
As long as the POLST is valid; meaning signed and dated by the patient/POA and patient’s provider and indicates that the patient’s code status is DNR, CPR can legally be withheld and the patient’s/family’s wishes can be honored without obtaining further medical direction.
Often times these POLST forms may be only partially filled out (i.e. only signed by the patient and not their physician/provider or not dated, etc.) In this case I would consult medical direction to discuss.
Questions from the Field
I’ve been reading conflicting procedures in the use of a tourniquet. If a patient has a bleed around the ankle, should the tourniquet be just proximal to the wound or put up on the thigh (single bone)? Was wondering because of the ischemia it would cause the leg"
We continue to recommend applying the tourniquet “high and tight” for extremity injuries and at least a “hand palm” width above the injury, never over a joint. It has been found, that even for prolonged applications of the tourniquet, long term CMS injury to the distal extremity is limited. Orthopedic surgeons use the intervention frequently for joint replacement, etc, to limit bleeding, with positive outcomes. In order for a tourniquet to work adequately, it has to be placed over the part of the extremity that has a single bone in order to get adequate compression.
MJM Medical Direction Consortium Services
MJM Medical Direction Consortium is a registered 501(c)3 organization. All donations are tax deductible in full or in part.