HomeMy WebLinkAboutalcoems-2018-fm-updatepowerpoint“Treatment algorithms should be used as a guideline
and are not intended
as a substitute for sound medical judgment”
“Unusual patient presentations
make it impossible to develop a protocol
for every possible patient situation”
DV Suspected
Non-Transport
If feasible, Conduct DV Lethality screen. If pt screens
HIGH RISK, call Family Violence Law Center (FVLC)
hotline. (800) 947-8301
Briefly describe circumstance without
identifying patient
If patient consents to speaking with FVLC advocate,
hand patient the phone
If patient does not consent to speaking with FVLC
advocate, give patient discreet FVLC resource
information and advise that he/she can call 24/7
Repeat basic safety planning tips that the FVLC
advocate provides
DV Suspected
Transport
Inform receiving facility of DV incident and presence
of law enforcement on scene
Base Contact Consultation
Is No Longer Required
in
Burn Patient Care
Crush Syndrome
Hyperkalemia
Of course, contact the
Base Physician
anytime consultation
in the patient’s best
medical interest
CPR
Lucas and Auto Pulse
Contraindications
Listed per
Manufacturer
Guidelines
CPR
Recommendations
Updated to
2015 AHA Guidelines
Trained
911 EMTs
May
Monitor SPO2
Perform Glucometry
Administer Epinephrine via Auto-Injector
to Anaphylactic Patients
Administer ASA
to Chest Pain Suspect Cardiac/STEMI Patients
Administer Naloxone
to Respiratory Depression Patients
with Suspected Narcotic OD
Albuterol Added
Base Contact No Longer Required Prior to
Administering Medications
Hydroxocobalamin (B12) Made Be
Substituted for Sodium Thiosulfate
in Patients with
Smoke Inhalation/Cyanide Poisoning
Hydroxocobalamin Dose
5 grams over 15 minutes
Added Note:
Facial/Oral Swelling (Angioedema)
Can Accompany Anaphylaxis,
But Is Not Always Present
Inadequate Tissue Perfusion
Types
Distributive –Most Common (66%)
Hypovolemic (16%)
Cardiogenic (16%)
Obstructive (2%)
Tx (VIP)
Ventilations
IV Fluids
Pressors
Treatment
TCP
Consider
Atropine
OR
Push Dose Epinephrine
while waiting for TCP
Dopamine Removed
Note Consider Hyperkalemia
Dysrhythmia
YES
Go To Appropriate
Dysrhythmia Protocol
Dysrhythmia
NO
If Clear Lung Sounds
Fluid 250-500ml
Push Dose Epinephrine
Dopamine Removed
B/P < 90
P < 60
Atropine
TCP
If BP < 90 AND P < 60 Continues
Consider Fluid and Push Dose Epi
B/P < 90
P >60
Fluid
Consider Push Dose Epinephrine
Dopamine Removed
SIRS Criteria Suspected Infection
>= 2 of the
following
Temp > 100.4 / < 96
HR > 90
RR > 20Monitor
ETCO2
Tx
Call Sepsis Alert
Initiate Fluids
If S/S of Shock
Administer Fluid Boluses
Up to 30ml/kg
If Continued S/S of Shock
After 30ml/kg Fluid
Consider Push Dose Epi
NALOXONE
ADULT
Titrate initial dose up to 2mg IN/IM/IV
PEDIATRIC
0.1 mg/kg up to 2mg IN/IM/IV
(BLS may administer IN ROUTE ONLY)
May repeat titrated to maintain adequate
ventilations and airway control.
Modified Note for
Epinephrine 1mg/ml, 0.01mg/ml IM
Max dose 0.5mg
“In Elderly, Small, History Of CAD,
Hypertension, Consider Lower Dose”
Routine suctioning
of vigorous, full term
newborns at birth
is not indicated.
Wiping the face, nose, mouth
is preferred.
When
NOT to
Do It
Fracture in target bone
Previous, significant
orthopedic procedure at the
site, prosthetic limb or joint
IO catheter use in past 48
hours of the target bone
Infection
at the area of insertion
Excessive tissue (severe obesity)
and/or absence of adequate
anatomical landmarks
Patient Centered
Evidence-Based Medicine
http://www.acphd.org/ems/manual_policies_plans.aspx
http://www.alcoems.org