BLS

Question 0

AIRWAY OBSTRUCTION (Foreign Body)
S-121

Answer 0

BLS

For a conscious patient:
Reassure, encourage coughing
O2 prn

For inadequate air exchange:
Airway maneuvers(aha) 
Abdominal thrusts 
Use chest thrusts in an obese or pregnant patient 

If patient becomes unconscious or is found unconscious:
Begin CPR

Once obstruction is removed:
High flow O2, ventilate prn
O2 saturation prn

ALS

If patient becomes unconscious or has a decreasing LOC:
Direct laryngoscopy and Magill forceps SO MR prn
Capnography SO prn

Once obstruction is removed:
Monitor/EKG
IV/IO SO adjust prn

Question 1

Abdominal Discomfort / GI/ GU (non-traumatic)

S-120

Answer 1

BLS

Ensure patent airway

O2 saturation prn

O2 and/or ventilate prn

NPO

Transport suspected symptomatic aortic aneurysm to facility with surgical resources immediately available.

ALS

Monitor EKG

IV/IO SO Adjust prn

Treat pain as per Pain Management Protocol (S-141)

For suspected volume depletion:
500ml fluid bolus IV/IO SO

In suspected symptomatic aortic aneurysm:
Titrate fluid to systolic BP 80

For nausea or vomiting:
Zofran 4mg IV/IM/ODT SO, MR x 1 q10” SO

Question 2

ALLERGIC REACTION / ANAPHYLAXIS

S-122

Answer 2

BLS

Ensure patent airway

O2 saturation prn

O2 and/or ventilate prn

Remove stinger/injection mechanism

May assist patient to self medicate own prescribed EpiPen or MDI ONE TIME ONLY. Base hospital contact required prior to any repeat doses.

ALS

Monitor EKG
IV/IO SO adjust prn
Capnography SO prn

Allergic Reaction: Mild (rash, urticaria)
Benadryl 50mg IV/IM SO

Allergic Reaction: Acute (facial/cervical angioedema, bronchospasm or wheezing)
Epinephrine 1:1000 0.3mg IM SO. MR x2 q10” SO
Benadryl 50mg IM/IV SO
Albuterol 6ml 0.083% via nebulizer SO. MR SO
Atrovent 2.5ml 0.02% via nebulizer added to first dose of Albuterol SO

Anaphylaxis: (shock or cyanosis)
Epinephrine 1:1000 0.3mg IM SO. MR x2 q10” SO

500ml fluid bolus IV/IO for systolic BP>90 SO. MR to maintain systolic BP> 90 SO

Benadryl 50mg IM/IV SO

Albuterol 6ml 0.083% via nebulizer SO.MR SO

Atrovent 2.5ml 0.02% via nebulizer added to first dose of Albuterol SO

Epinephrine 1:10,000 0.1mg IV/IO BHO. MR x2 q3-5” BHO

Dopamine 400mg/250ml @ 10-40mcg/kg/min IV/IO drip; Titrate systolic BP>_90 BHO

Question 3

ALTERED NEUROLOGIC FUNCTION (Non-traumatic)

S-123

Answer 3

BLS

• Ensure patent airway, O2 and/or ventilate prn
• O2 saturation prn
• Spinal stabilization prn
• Do not allow patient to walk
• Restrain prn

Secretion problems:
-position on affected side

Hypoglycemia: (suspected) or patients glucometer reads BS<4 hours in duration, expedite transport.

• Make initial notification early to confirm destination.
• Use the prehospital stroke scale in the assessment of possible CVA patients (facial droop, arm drift and speech abnormalities).
• Only use supplemental O2 to maintain O2 saturation 94-98%.

Seizures:

• Protect airway, and protect from injury.
• Treat associated injuries

Behavioral Emergencies:
-(Treat per S-422 and S-142).

Question 4

Burns

S-124

Answer 4

BLS

• Move patient to safe environment
• Break contact with causative agent
• Ensure patent airway, O2 and/or ventilate prn.
• O2 saturation prn
• Treat orther life threatening injuries.

Thermal Burns:

Burns of 10% body surface area (BSA).

• Cover with dry dressing and keep warm.
• Do not allow the patient to become hypothermic.

Chemical Burns:

• Brush off dry chemicals.
• Flush with copious amounts of water.

Tar Burns:

• Cool with water.
• Transport
• Do not remove tar.

Question 5

Discomfort / Pain of Suspected Cardiac Origin

S-126

Answer 5

BLS

• Ensure patent airway
• O2 saturation prn
• O2 and/or ventilate prn
• Do not allow patient to walk

If systolic BP>_100:

• May assist patient to self medicate own prescribed NTG SL (maximum 3 does, including those patient has taken).
• May assist placement of 12 lead.