Term
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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 |
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Term
| Supraventricular Tachycardia PERFUSING |
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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. |
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Term
| Supraventricular Tachycardia UNCONCIOUS or POOR PERFUSION |
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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. |
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Term
| V-Tach with Pulses PERFUSING |
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Definition
1. General ALS
2. Rapid transport |
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Term
| V-Tach with Pulses UNCONSCIOUS OR POOR PERFUSION |
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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. |
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Term
| Cardiopulmonary Arrest V-FIB OR PULSELESS V-TACH NON-TRAUMATIC |
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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 |
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Term
| CARDIOPULMONARY ARREST ASYSTOLE OR PEA <60 NON-TRAUMATIC |
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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 |
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Term
| CARDIOPULMONARY ARREST TRAUMATIC |
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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 |
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Term
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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. |
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Term
| RESPIRATORY DISTRESS ARREST/HYPOVENTILATION (RR < 8/MINUTE) |
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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. |
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Term
| RESPIRATORY DISTRESS BRONCHOSPASM/WHEEZING |
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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 |
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Term
| RESPIRATORY DISTRESS BASILAR RALES - CARDIAC ORIGIN (ADULTS ONLY) |
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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 |
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Term
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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. |
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Term
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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. |
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Term
| ALTERED LEVEL OF CONCIOUSNESS |
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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 |
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Term
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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. |
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Term
| PAIN MANAGEMENT ISOLATED EXTREMITY INJURY |
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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. |
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Term
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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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