-
PEA / Asystole (6 steps)
- 1) Start CPR
- 2) Adv. Airway
- Continuous Compressions 100/min
- Vent. 8-10/min - 2min Cycles
- 3) IV/IO w/ 500mL Normal Saline
- Epi 1:10,000 1mg (2mg ETT) q 3-5
- or 40units Vasopressin
- 4) Reversible Causes
- BGL less then 60 w/ IV 25g of D50%
- No IV 1mg Glucogon IM
- Opiate OD - 2mg Narcan appropriate route
- 5) Rhythm Check q 2mins
- If VT/VF follow SO for VT/VF
- 6) Contact Medical Control
- **Terminate only after MC input, and after
- Adv. Airway w/o reversible causes.
- **20cc flush after all meds
- **50cc max ETT
-
Active Seizures (5 steps)
- 1) Secure Airway
- 2) IV access
- 3) ALS witness 2mins or more, or repeat
- seizure
- 2mg Ativan IVP
- 5mg Valium IVP
- No IV access -
- 5mg Versed 2mg Ativan
- by appropriate route
- 4) BGL -
- Less then 60 25g of D50 IV
- No IV, 1mg Glucogon IM
- 5) Contact Medical Control
-
Allergic Reaction (5 steps)
- 1) Secure Airway
- 2) o2 if indicated
- 3) IV access
- 4) 50mg Benadryl IVP
- 5) Contact Medical Control
-
Anaphylaxis (8 steps)
- **with any -
- Resp. Distress
- Cool, Clammy, Mottled skin
- Hypotension BP </= to 90 systolic
- Altered Mental Status
- Delayed Capillary Refill
- 1) Secure Airway
- 2) o2 if indicated
- 3) 0.3mg Epi 1:1000 IM Deltoid or Lat. Thigh
- 4) If wheezeing 2.5mg/3mL Albuterol Neb
- Repeated x1
- 5) IV access w/ 500mL NSS
- **Repeat up to 1L if systolic less then 100
- and rales are not present**
- 6) 50mg Benadryl IV
- 7) 125mg Solu-Medrol IV
- 8) Contact Medical Control
-
Bradycardia (6 Steps)
- 1) Secure Airway
- 2) 12 lead
- 3) IV access
- **No IV pace**
- 4) No signs/symptoms of MI
- No Heart Transplant
- 0.5mg Atropine q 3-5mins max 3mg
- 5) No Response or Signs/Symptoms of MI
- Pace - 70BPM @ lowest mA's for capture
- 6) Contact Medical Control
- **Mobitz type 2 or 3rd degree, apply
- pacer pads **
-
Burn Management (13 steps)
- 1) Stop Burning Process
- 2) If Hazmat
- Take Precautions
- Contact Medical Control
- 3) C-Spine if indicated
- 4) Secure Airway - If trauma go to SO
- 5) Consider ETT for airway burns
- 6) o2 if indicated
- 7) Cover w/ dry sterile dressings
- 8) Maintain body temp
- 9) Transport decesion
- 10) IV access
- 11) 1L of NSS or LR's
- 12) BP of 90 systolic
- 0.1mg/kg Morphine max 10mg
- 1mcg/kg Fentanyl max 100mcg
- 13) Contact Medical Control
-
Non Traumatic Hypotension (4 steps)
Sys BP <90 w/o trauma or bradycardia
- possible sepsis
- dehydration
- no significant bleed
- shock
- 1) Secure Airway
- 2) IV access w/ 500mL bolus of NSS
- 3) Reassess vitals
- 4) Contact medical control
-
Nerve Agent Poisoning (4 steps)
- 1) Scene Safety and ensure Decon
- 2) Assess for SLUDGEM
- 3) Determine level of exposure
- **MILD** Conscious and Breathing
- Secure Airway
- Hi-flow o2
- Observe for Resp. Distress
- IV access
- **Severe** Unconscious w/ Resp.
- distress
- Secure Airway
- Hi-Flow o2
- IV access
- 2mg Atropine IV
- 1g Pralidoxime IV
- **NO IV use NAAK auto injector kits
- 2mg Atropine, 600mg Pralidoxime**
- 4) Contact medical control
-
Pulmonary Edema / CHF (8 Steps)
- 1) Secure Airway
- 2) o2 if indicated
- 3) 0.4mg Nitro SL q5min
- w/ BP >/=100 systolic
- 4) 12 lead
- 5) If MI 324mg ASA (include already taken)
- 6) IV access7) 20mg Lasix or 0.5mg Bumex
- 8) Contact medical control
-
COPD Bronchospasm w/ Wheeze (5 steps)
- 1) Secure Airway
- 2) 0.5mg Atrovent + 2.5mg Albuterol in
- 3mL Nebulizer
- 3) IV access
- 4) Reassess; repeat 2.5mg/3mL Albuterol
- x2
- **If CHF/Pulm Edema go to SO**
- 5) Contact Medical Control
-
Chest Pain / AMI (8 steps)
- 1) Secure Airway
- 2) o2 if indicated
- 3) ASA 324mg PO (Include already taken)
- 4) 12 lead
- 5) 0.4mg Nitro SL q 5min if sys BP >/= 100
- 6) IV access
- 7) Consider Thrombolytic eligibility
- 8) Contact Medical Control
-
Unconscious / AMS (5 steps)
- 1) Secure Airway
- 2) BGL
- If less than 60 - 25g D50% w/ IV
- No IV - 1mg Glucogon IM
- Possible Stroke - Neuro Exam
- 3) IV access
- 4) BGL greater than 60 or no response
- Administer 0.4mg max 2mg Narcan to
- reverse resp. depression
- 5) Call medical control
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