ALS TO BLS PROTOCOL Flashcards
Abdominal pain
male >30 female > 45 cardiac until proven otherwise;
females 12-50 yo possible ectopic pregnancy with syncope and systolic BP <90
not alert
Allergies: hives- medication reactions-stings
swelling around face, mouth or nose that impairs the airway - difficulty breathing - known hx. of anaphylaxis, signs getting worse - not alert
Animal bites - attacks
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.
Assault or rape
any dangerous injuries, airway compromise, not alert
uncontrolled hemorrhage
Back pain (non-trauma)
rule out AAA - or possible kidney stones - refer to pain management protocol if necessary. fainting and AGE over 50 yo. SUDDEN ONSET
Breathing problems
cannot maintain own airway; HOME apnea monitor - don’t assume hyperventilation
Burns - explosion
chemical or hazmat - burns around eyes nose or mouth - more than 15% is trauma alert - not alert or difficulty breathing - barotrauma for explosions
Carbon monoxide - inhalation - hazmat
not alert, abnormal VS, difficulty breathing , any hazmat incident
Chest pain
any patient 30 years or older
suspected cocaine use, not alert, cool pale and diaphoretic with cardiac hx.
choking
currently signs of obstructed airway
convulsions/seizures
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
Diabetic problems
glucose less than 60
unconscious or not alert
abnormal breathing (kussmaul respirations)
high blood sugar with signs of hyperglycemia (coma)
drowning/near drowning - diving accident
consider C-spine injury
scuba accident
not alert
abnormal breathing
electrocution - lightning
see trauma alert criteria
ALS
Eye problems/injuries
serious injuries or bleeding
hazmat
not alert
falls/traumatic back injuries
dangerous associated injury spinal no feeling or numbness below site of injury not alert 3 years old or less no movement below the injury
Headache
worst headache of life
recent head injury (within 48 hours)
possible stroke (FASTED SCALE)
hx of cerebral aneurysm
Heart problems
home EKG monitor
chest tightness, crushing, diaphoretic
recent coca use within 1 week
firing of IMPLANTED DEFIBRILLATOR
Heat or cold exposure
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
Hemorrhage and lacerations
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
Industrial machine accident
amputation take to TGH
keep amputated part cool but not on ice
wrap in wet gauze
Overdose - indigestion - poisoning
not alert can't speak abnormal breathing depression meds cocoaine acid or lye 3 years old or less
Pregnancy - childbirth - miscarriage
any 2nd or third trimester bleeding
baby born in distress with APGAR less than 7
abnormal presentation of birth
high risk complications of pregnancy
psychiatric or suicide attempt
glucose less than 70
AMS
hanging, strangulation or suffocation
suspicion of overdose
Gunshot wound - Stab
not alert central wounds are trauma alert uncontrolled hemorrhage abnormal breathing hypotension
Stroke - CVA
any weakness, paralysis, deficit numbness not alert abnormal breathing signs are not baseline for patient
Traffic accidents
3 years old or less bleeding disorders - hemophiliac meets the trauma alert criteria not alert abnormal breathing
unconscious - fainting
multiple recent fainting episodes females with abdominal pain 12-50 years old abnormal breathing not alert cardiac history included
