The links below represents a wide range of topics in news articles, resources, and journal articles. The views and opinions expressed are those of the author(s) identified in the respective articles, and do not necessarily reflect the views of Odyssey Medical, or the author of this blog post.
[Canadian Medical Association Journal] Do physicians require consent to withhold CPR that they determine to be nonbeneficial?
Are there ethical/religious consideration?
[Australia] Dr Jonathan Brett testing music festival portaloo wastewater
Do we really know what patrons are taking at music festivals? Would a retrospective analysis help drive policy decisions?https://t.co/n5O29Ntrb3
Harm Reduction – Australia
It is interesting to see how two neighbouring Australian jurisdictions continue to handle the issue of drugs and music festivals in wildly different manners. Despite the Coroners Court of New South Wales’s very lengthy recommendation to the NSW government in November 2019, the NSW Premier has reportedly chosen to go a different path forward. Meanwhile, the Australian Capital Territory government is pushing harm reduction measures across Australia.
[New South Wales] Drug deaths inquest: Gladys Berejiklian says she is ‘closing the door’ on pill testing
[Australian Capital Territory] ACT pushes for national pill-testing after study finds it encouraged people to ditch unsafe drugs
Harm Reduction – Canada
[Toronto] From zero tolerance to open dialogue: How harm reduction is shifting the conversation on drug use
Can we have an open and honest dialogue about drug use? We know it happens – avoiding discussion does not resolve the public health issue.
[Canada] Moving Benadryl behind the counter doesn’t resolve safety concerns: pharmacists
Is diphenhydramine on its way out from regular use as a non-prescription product?
[Toronto] ‘It changed my life’: New pilot project tests health benefits of social prescribing
How does social isolation and loneliness affect health? What is social prescribing (as opposed to a prescription for medication?)
Resource/Guidance documents (Australia)
Australian Disaster Resilience Knowledge Hub
Safe and Healthy Crowded Places Handbook https://knowledge.aidr.org.au/media/5914/crowded-places-handbook.pdf
Guidelines for music festival event organisers: music festival harm reduction https://www.health.nsw.gov.au/aod/Publications/music-festival-guidelines.PDF
Articles of Interest – Regulation
Major shakeup in regulation of health professionals proposed in B.C. https://www.cbc.ca/news/canada/british-columbia/bc-health-regulation-announcement-1.5375422
Articles of Interest – Research
Impact of mass gathering events on emergency healthcare services: informing health service planning for safer communities
DJ Mag partners with the Global Drug Survey
“Smashing Into Crowds” — An Analysis of Vehicle Ramming Attacks
From Jordan: “The article certainly makes the case for “vehicle interdiction measures” for the public, especially mass gatherings.”
Articles of Interest – Harm Reduction
[Australia] Victorian ambulance union calls for ‘back-of-house’ pill testing at music festivals this summer
[Australia] It’s a victory for common sense’: NSW music festival bill passes
Articles of Interest – Others
Surrey hospital to start emergency physician residency program
We received a couple of interesting questions last month, submitted by Nathan Innes (Ontario). He has been having some conversations with colleagues and trying to figure out answers to the following:
- Is the insertion of a nasopharyngeal airway (NPA)
within the scope of practice for a paramedic (PCP, ACP, CCP)?
- Is the insertion of a NPA in scope for other types of
health care providers?
History of NPAs
Believe it or not, the
first NPA was invented in the 1870s and it took another few decades for the
oral airway to be invented. NPAs are also known as “nasal trumpets” or “nose
hoses.” They are a good option for airway management if you have a patient who
is too intoxicated to maintain a consistent airway without assistance, but
awake enough that the gag reflex is still intact (and so not a candidate for an
Nerdy, interesting paper about NPAs (a classic): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1726817/pdf/v022p00394.pdf
So, in this case, answering Nathan’s questions directly…
General Approach to Any Scope of Practice
Whenever you are going
to intervene/treat a patient, ask yourself the following questions (the 3 S
Approach – Scope, Support, Skill):
- Is this within my SCOPE
of practice as a professional?
- Is this intervention/treatment SUPPORTED by a clinical protocol?
- Do I, personally, have the training, knowledge and SKILL to perform a particular
- Do I understand the indications, risks, alternatives
and contraindications for a given intervention/treatment?
- Do I have the ability to manage complications that may
- Do I understand the indications, risks, alternatives
SCOPE: Yes, inserting a NPA is within scope for emergency medical responders
(EMRs), paramedics (PCP, ACP, CCP) and nurses (LPNs, RPNs, RNs) in Ontario,
Alberta and British Columbia.
SUPPORTED: Yes, this intervention is supported by Odyssey Medical for providers who have this in their SCOPE, and who have received the training and are comfortable with the SKILL. We don’t have a specific written protocol for the insertion “How To’s” of NPAs because it is not our goal to reproduce textbooks specific to each credential and level of training. The insertion of NPAs is part of BLS management of an unstable airway. Some quick resources if you wish to review:
Nathan, thanks for
Why is one end of a