AMS Protocol

Question 1

Initial Intervention

Answer 1

A. Obtain Hx if possible
B. Quick physical exam with emphasis on cardiopulmonary resuscitation and neurologic status
1. Assume head and spine injury is a possibility and treat accordingly
C. Protect airway- suction, airway control, etc. prn

Question 2

Treatment

Answer 2

A. 100% O2
1. Intubation prn
B. Glucoscan
1. Repeat after D10 administration
2. Normal CBG 60-120mg/dL.
C. IV balanced salt solution TKO
D. EKG
E. Thiamine 100 mg IV if EtOH abuse likely
F. Dextrose 10 gms infusion if hypoglycemic, may repeat 5gm prn to max 25gm. Child 0.1 gm/kg, may repeat x2 every 5 min prn
G. Narcan dosing regimen
1. Resp. depression/ apnea 2.0 mg IV, IN, IM; may repeat x2. Child >5 y/o (or 20 kg) 0.1 mg/kg
2. Altered mentation (O2 sat, EtCO2 normal) titrate 0.5mg prn to maintain airway and respirations. Do not exceed max dose as above.
-Note- If pt opiate dependent consider titrating dose and prepare for Sx pf withdrawl. Observe carefully during transport for changes in LOC, airway, pupils, and V/S.