CPR,Advanced Airway,300cc bolus, may repeat,epi 1:10,000 1mg during every 2 min of CPR after each rhythm eval,1.0mg Atropine after 2nd cycle of CPR to max of 3.0mg, consider termination PEA<60, asystole, agonal rhythm, successful intubation, initial meds
Cardiac Arrest (old)VF/VT
start cpr, advanced airway, defib 360 v tach/fib, 2 min cpr after defib, epi 1:10,000 1mg, reassess, defib if VF/VT, after 2 cycles of Cpr lido 1.5mg/kg repeat 0.75mg/kg every 5, call base after 5 cycles
Allergic reaction/anaphylactic shock
Nebulized atrovent/albuterol,2.5/.5 3times,CPAP,epi .3 1:1,000 repeat after 15 min,Diphenhydramine 25mgIV,50IM,EPI 1:10,000 .1mg as needed to .5mg, nasotracheal intubation
Pedestrain, significant blunt trauma to, extrication
auto pedestrain with significant impact >10mph, auto bicycle with significant impact >10mph,pedestrian thrown >15feet or run over. significant blunt trauma to head, neck, or torso. extrication >20 min with associated injuries.
contraindications for EMS aircraft
HAZ MAT pts who can't be decontaminated, violent or under the influence or drugs or alcohol pts, stable pts,ground transport<30,traumatic cardiac arrest,other safety considerations determined by crew/pilot.
cold related:severe hypothermia
severe=advanced airway,>9y/o 300cc warmed may repeat,birth-8y/o 20ml/kg warmed may repeat,strip,VF/VT pulseless=defib 1 at 2/kg or 200,asystole=Cpr,additional bolus
Critical Trauma Patient anatomic penetrating injuries to, blunt chest trauma resulting in, severe tenderness to,
penetrating injuries to:torso,head,extremity proximal to the knee or elbow,neck,groin.blunt chest trauma resulting in:eccymosis,unstable chest wall,flail chest.severe tenderness to:head,neck,torso,abdomen,pelvis.
Trauma blunt force, penetrating trauma, isolated closed head injury
unstable=IV NS open til stable or 2000ml infused, stable IV NS TKO.Penetrating trauma=unstable IV NS 500ml,stable" ". Isolated closed head injury=unstable:IV NS 250ml to max 500ml,stable IV NS TKO
Trauma adult Respiratory
Advanced airway as indicated,unmanageable airway=transport to the closest most appropriate.Requires intubation=airway can't be maintained with BVM,unable to intubate.For all calls:Monitor ECG warm IV fluids when available, unstable=BP<90 start 2nd IV,
Cold related: frostbite/mild hypothermia
frostbite=elevate,IV,pain relief=2mg MS up to 10mg IV/10mg IM adult, .1mg/kg up to 2mg, up to 5mg,.2IM to 10, RCF may repeat MS.Mild hypothermia=IV,monitor,glucose.
