Term
| Indications for Medical Cardiac Arrest |
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Definition
| Non-traumatic cardiac arrest |
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Term
Conditions for
Manual Defibrillation |
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Definition
Age: ≥ 30 days
LOA: Altered
Other: VF or pulseless VT |
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Term
Medical TOR
requires what? |
|
Definition
Age: ≥ 18 years
LOA: Altered
Other: Arrest not witnessed by EMS, AND No ROSC AND No Shocks delivered |
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Term
| Epinephrine can be used by a PCP in a medical cardiac arrest when? |
|
Definition
LOA: Altered
Other: Anaphylaxis suspected as causative event |
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Term
| A Medical TOR is contraindicated when? |
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Definition
Arrest thought to be of non-cardiac origin
(or when the TOR doesn't apply) |
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Term
Manual Defibrillation treatment for a Medical Cardiac Arrest
Age: ≥ 30 days
to < 8 years |
|
Definition
1st shock: 2J/kg
Subsequent and max dose: 4 J/kg
Interval: 2 mins
Max # of doses: 4 |
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Term
Manual Defibrillation treatment for a Medical Cardiac Arrest
Age: ≥ 8 years |
|
Definition
1st shock: As per BH / Manufacturer
Subsequent and max dose: As per BH / Manufacturer
Interval: 2 mins
Max # of doses: 4 |
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Term
| Medical Cardiac Arrest Mandatory Patch Point is done when? |
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Definition
| Patch to BHP for authorization, following 3rd analysis, to consider Medical TOR if applicable. If BH patch fails, or the medical TOR does not apply, transport to the closest appropriate receiving hospital following ROSC or the 4th analysis. |
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Term
Medical Cardiac Arrest
Clinical Considerations |
|
Definition
In unusual circumstances (e.g. pediatric pt's or toxicological overdoses), consider initiating transportation following the first rhythm analysis that does not result in a defibrillation being delivered.
A Paramedic may choose to move the pt to the ambulance prior to initiating the TOR if the family is not coping well or the arrest occured in a public place.
Deceased Pt Standard once TOR has been implemented. |
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Term
| Indications for Trauma Cardiac Arrest Medical Directive |
|
Definition
| Cardiac arrest secondary to severe blunt or penetrating trauma |
|
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Term
| Trauma Cardiac Arrest TOR requires what? |
|
Definition
Age: ≥ 16 years
LOA: Altered
Other: No palpable pulses
No defibrillation delivered and monitored HR = 0 (asystole) OR monitored HR > 0 AND the closest ER ≥ 30 min transport time away. |
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Term
| A Trauma TOR is contraindicated when? |
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Definition
Age: < 16 years
Shock delivered
Monitored HR > 0 and closest ER <30 min away |
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Term
Manual Defibrillation treatment for the Trauma, Hypothermia and FBAO Cardiac Arrest Directives
Age: ≥ 30 days
to < 8 years |
|
Definition
1st (and only shock):
2 J/kg
Max # of doses: 1 |
|
|
Term
Manual Defibrillation treatment for the Trauma, Hypothermia and FBAO Cardiac Arrest Directives
Age: ≥ 8 years |
|
Definition
1st (and only shock):
As per BH / Manufacturer
Max # of doses: 1 |
|
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Term
Trauma Cardiac Arrest
Clinical Considerations (what 5 things don't count as trauma under this directive) |
|
Definition
If no obvious external signs of significant blunt trauma, consider medical cardiac arrest.
Always treat as medical: Drowning, Electrocution, Commotio Cordis, Overdose, Hanging |
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Term
| Indications for Hypothermia Cardiac Arrest |
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Definition
| Cardiac arrest secondary to severe hypothermia |
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Term
| Unique to the Foreign Body Airway Obstruction Cardiac Arrest Medical Directive |
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Definition
| If the pt is in cardiac arrest following removal of the obstruction, initiate management as a medical cardiac arrest....if the obstruction cannot be removed, transport to the closest appropriate facility following the first analysis |
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Term
| Indications for Neonatal Resuscitation Medical Directive |
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Definition
| Severe cardio-respiratory distress |
|
|
Term
| Conditions for Neonatal Resuscitation Medical Directive |
|
Definition
Age: newborn or < 30 days of age
Other: Less than full term, or merconium, or poor APGAR score |
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