Cardiac Arrest Protocol

1. Assess the patient and manage ABC’s.

2. Begin CPR. Hyperventilate patient with 100% O2 via BVM.

3. Apply AED as soon as possible. Follow the voice prompts.

4. Intubate patient.

5. Initiate an IV of Normal Saline [0. 9 %] at KVO rate.

6. Contact Medical Control. 

Suspected Acute Myocardial Infarction / Chest Pain

Myocardial infarction is often characterized by substernal chest pressure with associated diaphoresis, dyspnea, vomiting and pallor but may be asymptomatic or atypical.

ACTIONS:

1. Assess the patient and manage ABC’s.

2. Administer O2 to maintain oxygen saturation > 96%. If on home O2, then maintain oxygen saturation > 90%

3. IV Normal Saline [0.9%] at a KVO rate.

4. Assist the patient with self-administration (chew) of four (4) baby aspirin (324mg). 

Note:  Drugs must be in possession of patient and have been prescribed by a physician.

Contraindications:  Active Ulcer, Hypersensitivity to Aspirin, Suspected aortic dissection

5. If SBP is > 90 assist the patient with one (1) Sublingual Nitrotab 0.4mg or one (1) Nitrospray 0.4mg. May repeat every five (5) minutes until a total of three (3) doses. Reassess after every dose. Note: Drugs must be in possession of patient and have been prescribed by a physician.

6. Contact Medical Control.

1. Always assess AMI patients for signs of CHF and, if present, contact Medical Control before initiating any fluid boluses.

Respiratory Distress

Respiratory distress is the end product of many disease processes, including asthma, chronic obstructive pulmonary disease [COPD] and congestive heart failure [CHF]. Accurate patient assessment is critical to determine appropriate treatment.

1. Assess the patient and manage ABC’s.

2. Administer O2 to keep sats > 96%. If on home oxygen, then maintain an oxygen saturation > 90%.

3. Intubate if necessary.

4. Initiate INT.

5. Contact Medical Contr ol.

Adult Altered Mental Status / Seizures / General Medical Protocol

GENERAL:   This protocol addresses the treatment of patients who do not fall under another more specific protocol.

1. Assess the patient and manage the ABC’s.

2. Provide supplemental O2 as needed.

3. Initiate INT as needed.

4. Give 300 cc bolus NS if SBP < 90. Reassess, if continued SBP< 90, may repeat bolus.

5. Do BGL.

6. Contact Medical Control.

Heat Related Illnesses

GENERAL:  This protocol addresses the treatment of patients who present with heat related signs and symptoms.

Heat related illness describes a broad range of conditions from heat exhaustion to heat stroke. Heat stroke is characterized by hot dry skin with sudden onset of altered LOC. Heat exhaustion is a form of hypovolemic shock which requires fluid replacement but not necessarily cooling measures.

ACTIONS:    

1. Assess the patient and manage ABC’s.

2. Administer O2 to maintain an oxygen saturation > 96% unless on home O2, then maintain an oxygen saturation > 90%.

3. Intubate as necessary.

4. Initiate an IV of Normal Saline [0.9%] as needed for tachycardia, severe heat cramps, and/or hypotension. If SBP < 90 administer a fluid bolus of 300cc Normal saline [0.9%] and reassess patient. Repeat 300cc bolus and reassessment until SBP > 90.

5. Initiate aggressive cooling measures if signs of heat stroke are present. Use cold wet sheets and ice packs to the axilla and groin.

6. Contact Medical Control.

Major Trauma

Major trauma should be determined by the mechanism of injury (MOI) [significant in blunt and penetrating trauma] as well as the observed injuries of the patient. Minor traumatic injuries may be managed with spinal precautions and only those ALS procedures indicated to the Intermediate through effective assessment.

* ON ALL SUSPECTED TRAUMA REFER TO SPINAL IMMOBILIZATION PROTOCOL *

ACTIONS:    

1. Assess the patient and manage ABC’s.

2. Administer O2 via nonrebreather at 15LPM.

3. Intubate if necessary.

4. Initiate an IV of Normal Saline [0.9%] with a large bore catheter at a KVO rate. If SBP < 90 administer a fluid bolus of 300cc Normal Saline [0.9%] and reassess patient. Repeat 300cc bolus and reassessment until SBP > 90. If necessary and time permits initiate a second large bore IV.

5. Contact Medical Control.

1. Airway management is the first priority. Trauma patients enroute to the Level I Trauma Center should be diverted to the closest facility for airway intervention before completing the transport if patient can not be provided with adequate airway support due to their injuries.

2. Head Injury: Assess BGL. For unresponsive patients aggressive airway intervention is appropriate.

3. Burns Injuries: Always assess the depth and extent of the burn injury. Aggressive airway intervention is vital for any patient with significant signs of airway involvement (soot in posterior oropharynx, singed nasal hairs or stridor/wheezing). Always provide oxygen via nonrebreather until carbon monoxide exposure is ruled out. Sterile dressings/burn packs may be applied as indicated.
 

HOME || Government || Community || Departments || Intranet