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Step 3 trauma activation vehicle speed
40mph vehicle
Or
20mph veh vs Ped or motorcycle
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What trauma activation levels are a consult?
3 and 4
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Golden hour definition
From injury time to arrival at trauma center
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Inappropriate use definition
Someone who’s accessed EMS 2x or more in 3 consecutive months (6x in 90 days)
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Trauma aircraft utilization criteria
Step 1 or step 2
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Medical aircraft utilization criteria
- ALOC unresponsive to D10 and Narcan
- Respiratory arrest or compromise
- Cardiac case - symptomatic dysrhythmia, post arrest, acute MI
- Symptomatic hypotension
- Anaphylaxis
- Status epilepticus
- Complications of childbirth
- Stroke
- Near drowning
- Hypothermic cardiac arrest
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Lidocaine dose for IO anesthetic
40mg lidocaine 2% slow IO push
Peds - .5mg / kg max 40mg
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Level II procedures
- Cricothyrotomy
- Needle thoracic decompression
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Needle T Cath size
10g, 3.25” long
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Level II Drugs
- Activated charcoal
- CaCl
- Diazepam
- Benadryl
- Dopamine
- Glucagon
- Mag Sulfate
- Midazolam
- Sodium Bicarbonate
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Can a paramedic give dosages higher than protocol during an IFT
Yes, with written MD order
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Potassium Chloride dosage limitation during IFT
<= 40meq / L
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Step 3 trauma hospital
Any
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Pediatric - emergent medical
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Pediatric - non emergent medical
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Sexual assault hospital
AH
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Stroke destination
Anywhere except BHH
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Palmdale regional hospital capabilities
- Ortho
- Cardiac
- Psych pt requesting transport
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Where to transport step 1 or 2 trauma pt w/ burns
KMC
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When to transport to burn center
- 2 or 3 deg to > 10%
- Circumferential burns of 2 or 3 deg
- 2 or 3 deg to hands, feet, face, major joints
- Perineum, genitals
- Elec burns > 120v
- Chem burns of > 5%
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Can CCN urges transfer care to paramedic?
Yes, if no medications on board that are outside paramedic scope
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Lidocaine Cardiac arrest dose
- 1.5mg/kg
- .75mg/kg subsequent doses
- Max total 3mg/kg
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Mag sulfate cardiac arrest dose
1-2g diluted in 10ml and given over 10min
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Body temp threshold for 1 shock cardiac arrest
30deg C / 86 deg F
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Body temp threshold for spacing med admin in cardiac arrest
30 - 34deg C / 86 - 93.2 F
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Lidocaine infusion dose
1-4mg / min
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Therapeutic hypothermia hospitals
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VT w/ pulse Amio dose
- 150mg in 100ml over 10min
- Repeat to 450mg max
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Torsades w/ pulse Mag sulfate dose
1-2g in 100ml over 5-20m
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Epi drip rate
2-8mcg / min
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Analgesic for TCP dosage
- 5mg morphine
- 50mcg fentanyl
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Chest pain nitro dosage
- .4 mg SL
- repeat as needed as long as BP above 90
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Stroke center time threshold
4hrs
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Stroke transport position
Semi Fowler’s <= 30 deg elevation
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Pediatric shock energy
4J/Kg
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Ped amiodorone dose
5mg/kg
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Pediatric lidocaine dose
- 1 mg/kg
- Repeat to max of 3 mg/kg
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Ped mag sulfate dose
25-50 mg/kg max 2 mg diluted in 10 ml NS given over 5-20min
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Pediatric cardioversion energy
.5 - 1 mg/kg
Increase to 2mg/kg
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Pediatric adensosine dose
.1 mg/kg
.2 mg/kg
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Ped epi drip dose
.1 - 1 mcg/kg/min
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Pediatric bradycardia atropine dose
.02 mg/kg
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Pediatric hypotension fluid dose
- 20ml/kg
- Repeat up to 60ml/kg, more with base contact
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Dextrose admin BGL for neonate resuscitation
>40, then 5ml/kg D10
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Neonate age upper limit
28 days... if older, follow pediatric protocol
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Hypoglycemia bgl threshold
- 60 for adults
- 35 for kids under 4 weeks
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Pediatric glucagon
.5 mg of under 8yo
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Narcan dose for < 5yo pt
.1 mg/kg
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Zofran max dose
12mg adults, 4mg peds... base for more
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