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Details

LA County Protocol 806.1
Procedures Prior to Base Contact
18
Health Care
Professional
09/12/2009

Additional Health Care Flashcards

 


 

Cards

Term
Symptomatic Bradycardia
Definition

1. General ALS

-Adult HR= < 40/min and SBP < 80 2. Atropine 0.5 mg IV

3. If no improvement, TCP

-Pediatric HR= <60/min

2. Ventilate with BVM @ 100% O2

3. CPR - if HR does not rise above 60/min with BVM

Term
Supraventricular Tachycardia PERFUSING
Definition

1. General ALS

ADULT:

2. Valsalva maneuver

3. If no conversion, Adenosine 6 mg rapid IVP, with rapid 10ml bolus.

4. If no conversion, Adenosine 12mg rapid IVP, with rapid 10ml bolus.

PEDIATRIC:

2. Rapid transport.

Term
Supraventricular Tachycardia UNCONCIOUS or POOR PERFUSION
Definition

1. General ALS

ADULT:

2. Adenosine 12mg rapid IVP, with rapid 10ml bolus. If no conversion may repeat one time.

3. Synchronized Cardioversion en route -100J monophasic or equivalent bi

4. If no conversion may repeat one time at 200J monophasic or equivalent bi.

PEDIATRIC:

2. Fluid challenge 20 ml/kg one time.

Term
V-Tach with Pulses PERFUSING
Definition

1. General ALS

2. Rapid transport

Term
V-Tach with Pulses UNCONSCIOUS OR POOR PERFUSION
Definition

1. General ALS

2. Synchronized Cardioversion:

ADULT: 100J monophasic or equivalent bi.

PED: 0.5J/kg monophasic or biphasic.

3. If no conversion, may repeat one time en route:

ADULT: 200J mono or equivalent bi.

PED: 1J/kg mono or biphasic.

Term
Cardiopulmonary Arrest V-FIB OR PULSELESS V-TACH NON-TRAUMATIC
Definition

1. BCLS/Cardiac monitor

2. Unwitnessed - 2 min CPR then defib Witnessed - defib and immediately resume CPR for 2 min.

-ADULT: 360J mono or equivalent bi

-PED: 2J/kg biphasic or mono.

3. Venous Access: if IV is not possible, place IO If hypovolemia, NS fluid challenge -ADULT: 10 ml/kg rapid IV/IO -PED: 20 ml/kg rapid IV/IO

4. Epinephrine (1:10,000) -ADULT: 1mg IV/IO -PED: 0.01mg/kg IV/IO

5. If no conversion, defib and immediately resume CPR for 2 min. -ADULT: 360J or equivalent bi -PED: 4J/kg biphasic or mono

6. If no conversion CPR.

7. Advanced airway prn: -PED: > 12 years or > 40kg

Term
CARDIOPULMONARY ARREST ASYSTOLE OR PEA <60 NON-TRAUMATIC
Definition

1. BCLS/cardiac monitor

2. Venous Access: if IV is not possible, place IO -If hypovolemia, NS fluid challengbe: -ADULT: 10 ml/kg rapid IV/IO -PED: 20 ml/kg rapid IV/IO

3. Epinephrine (1:10,000) -ADULT: 1mg IV/IO -PED: 0.01/ mg/kg IV/IO

4. Atropine: -ADULT: 1mg IV/IO -PED: not indicated

5. Advanced airway prn: -PED: > 12 years or >40kg

Term
CARDIOPULMONARY ARREST TRAUMATIC
Definition

1. BCLS - maintain spinal immobilization - if indicated.

2. Cardiac monitor IF V-FIB/PULSELESS VT:

3. Defibrillation -ADULT: 360J monophasic or equivalent biphasic. -PED: 2J/kg biphasic or monophasic

4. If suspected tension pneumothorax - needle thoracostomy en route.

5. Advanced airway prn: PED: > 12 years or > 40kg.

6. Venous access: enroute: if unable to establish IV access, place IO -ADULT: 10 ml/kg or wide open -PED: 20 ml/kg

Term
GENERAL ALS
Definition

1. Basic airway/high flow O2 -BVM and advanced airway prn

2. Cardiac monitor/document rhythm prn

3. If indicated, perform blood glucose test.

4. Establish venous access prn.

5. Pediatric Resuscitation Tape prn.

Term
RESPIRATORY DISTRESS ARREST/HYPOVENTILATION (RR < 8/MINUTE)
Definition

1. General ALS

2. If suspected narcotic OD with hypoventilation Naloxone prior to advanced airway placement. Titrate IV to adequate RR/TV:

-ADULT: 0.8-2 mg IV/IM -PED: 0.1 mg/kg IV/IM

3. May repeat prn.

Term
RESPIRATORY DISTRESS BRONCHOSPASM/WHEEZING
Definition

1. General ALS

2. Albuterol via hand-held nebulizer

-ADULT: 5mg -PED: 0-1 year = 2.5; > 2 year = 5mg

3. May repeat one time prn

Term
RESPIRATORY DISTRESS BASILAR RALES - CARDIAC ORIGIN (ADULTS ONLY)
Definition

1. General ALS

2. Nitroglycerin (NTG) SL or transmucosal:

-Systolic BP > 100 = 0.4mg

-Systolic BP > 150 = 0.8mg

-Systolic BP > 200 = 1.2mg

3. May repeat 2 times prn - based on repeat BP

4. Consider CPAP if available - max pressure: 10cmH2O

Term
CHEST PAIN
Definition

1. General ALS

2. NTG 0.4 mg SL or transmucosal, may repeat 2 times every 3-5 min if SBP > 100.

3. Aspirin 162 mg chewable.

4. 12 Lead ECG for suspected acute cardiac event

-if ECG = no suspected acute MI, transport to the MAR.

-if ECG = suspected acute MI, transport to the SRC.

Term
ACTIVE SEIZURE
Definition

1. General ALS.

2. Midazolam - titrate IV to seizure control.

-ADULT: 2-5 mg slow IVP if unable to establish an IV - 5mg IM or IN

-PED: 0.1 mg/kg IVP or if unable to establish an IV, o.1 mg/kg IM (max single ped dose = 5mg)

3. May repeat one time prn.

Term
ALTERED LEVEL OF CONCIOUSNESS
Definition

1. General ALS

2. Blood glucose administer Dextrose if < 60 or if known diabetic < 80.

-ADULT: 50ml D50 IV

-PED: 0-2 yrs = 2ml/kg D25 IV or > 2 yrs = 1ml/kg D50 IV --if unable to establish IV access, administer Glucagon 1mg IM.

3. If suspected narcotic OD with hypoventilation, Naloxone prior to advanced airway placement.

-ADULT: 0.8-2mg IV/IM or 2mg IN

-PED: 0.1mg/kg IV/IM --titrate IV to adequate RR/TV

Term
SHOCK
Definition

1. General ALS.

2. Fluid challenge NS: (if basilar rales-cardiogenic shock suspected - TKO)

-ADULT: 10ml/kg, assess lung sounds frequently.

-PED: 20ml/kg

3. If Anaphylaxis: Epinephrine

-ADULT: 0.3 mg IM (1:1000) --if severe, administer 0.1 mg slow IVP (1:10,000)

-PED: 0.01 mg/kg IM (1:1000)(Max single dose 0.3mg) --if severe, administer 0.01 mg/kg slow IVP (1:10,000) (max single dose 0.1mg)

4. If suspected tension pneumothorax = needle thoracostomy en route.

Term
PAIN MANAGEMENT ISOLATED EXTREMITY INJURY
Definition

1. General ALS.

2. Traction/splints/dressings prn

3. If moderate to severe pain, Morphine: titrate IV to effect.

-ADULT: 2-4mg IV/IM, if SBP > 100

-PED: 0.1 mg/kg IV/IM (max single dose = 4mg)

4. May repeat one time prn.

Term
PAIN MANAGEMENT BURN
Definition

1. General ALS

2. If moderate to severe pain, Morphine: titrate IV to effect.

-ADULT: 2-4mg IV/IM, if SBP > 100

-PED: 0.1 mg/kg IV/IM (max single dose: 4mg)

3. May repeat one time prn.

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