ALS TO BLS PROTOCOL

Question 1

Abdominal pain

Answer 1

male >30 female > 45 cardiac until proven otherwise;
females 12-50 yo possible ectopic pregnancy with syncope and systolic BP <90
not alert

Question 2

Allergies: hives- medication reactions-stings

Answer 2

swelling around face, mouth or nose that impairs the airway - difficulty breathing - known hx. of anaphylaxis, signs getting worse - not alert

Question 3

Animal bites - attacks

Answer 3

peripheral wounds that will not stop bleeding, any central bite wounds; large carnivores or zoo animals, any snake bites - keep bite below the level of heart.

Question 4

Assault or rape

Answer 4

any dangerous injuries, airway compromise, not alert

uncontrolled hemorrhage

Question 5

Back pain (non-trauma)

Answer 5

rule out AAA - or possible kidney stones - refer to pain management protocol if necessary. fainting and AGE over 50 yo. SUDDEN ONSET

Question 6

Breathing problems

Answer 6

cannot maintain own airway; HOME apnea monitor - don’t assume hyperventilation

Question 7

Burns - explosion

Answer 7

chemical or hazmat - burns around eyes nose or mouth - more than 15% is trauma alert - not alert or difficulty breathing - barotrauma for explosions

Question 8

Carbon monoxide - inhalation - hazmat

Answer 8

not alert, abnormal VS, difficulty breathing , any hazmat incident

Question 9

Chest pain

Answer 9

any patient 30 years or older

suspected cocaine use, not alert, cool pale and diaphoretic with cardiac hx.

Question 10

choking

Answer 10

currently signs of obstructed airway

Question 11

convulsions/seizures

Answer 11

CONSIDER CARDIAC ARREST IF 30 years or older
trauma
pregnant
diabetic
cardiac hx
first seizure without any history of seizures
3 years old or fewer

Question 12

Diabetic problems

Answer 12

glucose less than 60
unconscious or not alert
abnormal breathing (kussmaul respirations)
high blood sugar with signs of hyperglycemia (coma)

Question 13

drowning/near drowning - diving accident

Answer 13

consider C-spine injury
scuba accident
not alert
abnormal breathing

Question 14

electrocution - lightning

Answer 14

see trauma alert criteria

ALS

Question 15

Eye problems/injuries

Answer 15

serious injuries or bleeding
hazmat
not alert

Question 16

falls/traumatic back injuries

Answer 16

dangerous associated injury
spinal
no feeling or numbness below site of injury
not alert
3 years old or less
no movement below the injury

Question 17

Headache

Answer 17

worst headache of life
recent head injury (within 48 hours)
possible stroke (FASTED SCALE)
hx of cerebral aneurysm

Question 18

Heart problems

Answer 18

home EKG monitor
chest tightness, crushing, diaphoretic
recent coca use within 1 week
firing of IMPLANTED DEFIBRILLATOR

Question 19

Heat or cold exposure

Answer 19

not alert,
change in skin color 
heat stroke has red hot skin and no sweating with altered mental status
frostbite is pale, grey and numb skin
hypothermia has pale cyanotic with AMS

Question 20

Hemorrhage and lacerations

Answer 20

serious uncontrolled bleeding
blood thinners
neck, groin, armpit or rectum vomit blood
arterial bleeds from arm, abdomen, chest face or upper leg.
hypotensive, weak and thready pulse
difficulty breathing

Question 21

Industrial machine accident

Answer 21

amputation take to TGH
keep amputated part cool but not on ice
wrap in wet gauze

Question 22

Overdose - indigestion - poisoning

Answer 22

not alert
can't speak
abnormal breathing
depression meds
cocoaine
acid or lye
3 years old or less

Question 23

Pregnancy - childbirth - miscarriage

Answer 23

any 2nd or third trimester bleeding
baby born in distress with APGAR less than 7
abnormal presentation of birth
high risk complications of pregnancy

Question 24

psychiatric or suicide attempt

Answer 24

glucose less than 70
AMS
hanging, strangulation or suffocation
suspicion of overdose

Question 25

Gunshot wound - Stab

Answer 25

not alert
central wounds are trauma alert
uncontrolled hemorrhage
abnormal breathing
hypotension

Question 26

Stroke - CVA

Answer 26

any weakness, paralysis, deficit
numbness
not alert
abnormal breathing
signs are not baseline for patient

Question 27

Traffic accidents

Answer 27

3 years old or less
bleeding disorders - hemophiliac
meets the trauma alert criteria
not alert
abnormal breathing

Question 28

unconscious - fainting

Answer 28

multiple recent fainting episodes
females with abdominal pain 12-50 years old
abnormal breathing
not alert 
cardiac history included