EMS policies Flashcards
Allergic Reaction and Anaphylaxis
Administer oxygen as indicated
Anaphylaxis: Assist patient with prescribed epinephrine auto-injector, or
* If under 30 kg – Epinephrine 1 mg/mL
o IM - 0.15 mg via auto-injector, pre-filled syringe, or syringe/vial draw
o May repeat x 1 in 5 minutes if patient remains in distress
* If 30 kg and over – Epinephrine 1mg/mL
o IM - 0.3mg via auto-injector, pre-filled syringe, or syringe/vial draw
o May Repeat x 1 in 5 minutes if patient remains in distress
Altered Neurologic Function
If suspected stroke, refer to VC EMS Policy 705.26 – Suspected Stroke
Administer oxygen as indicated
Determine blood glucose level
If less than 60 mg/dl
* Oral Glucose – patient must be awake and able to swallow with a gag reflex intact
o PO 15 g
* Treat as above if you have clinical suspicion of hypoglycemia and are unable to obtain glucose level due to glucometer malfunction or error reading.
Chest Pain – Acute Coronary Syndrome
Administer oxygen if dyspnea, signs of heart failure or shock, or SpO2 < 94%
Assist patient with prescribed Nitroglycerin as needed for chest pain
* Hold if SBP less than 100 mmHg
Childbirth
Determine
* Number of pregnancies (gravida)
* Number of deliveries (para)
* Due date (weeks of gestation)
* Onset/duration/frequency/intensity of contractions
* If a rupture of membranes has occurred (including color/date/time)
* If any expected complications during pregnancy are present
* Presence of crowning or any abnormal presenting part at perineum
Neonatal Resuscitation
Newborn or Infant up to 48 hours old
Provide Warmth
Assess Responsiveness
◦ Flick soles of feet for infant or
◦ Assess newborn while drying
Ensure Adequate Ventilation
* Suction if secretions cause airway obstruction.
* If Apneic or gasping
◦ Positive pressure ventilations (PPV) with BVM and ROOM AIR at 40-60 breaths per minute
Ensure Adequate Circulation
* If HR between 60 and 100 bpm
◦ PPV with BVM and ROOM AIR at 40-60 breaths per minute
Continue PPV until infant maintains HR >100 bpm
* If HR < 60 bpm
◦ CPR at 3:1 ratio
Continue CPR until HR > 60 bpm
Correct Hypoxia
* If no improvement after 90 seconds of ROOM AIR CPR, add supplemental O2 until HR > 100
Nerve Agent / Organophosphate Poisoning
The incident commander is in charge of the scene and you are to follow his/her direction for entering and exiting the scene. Patients in the hot and warm zones MUST be decontaminated prior to entering the cold zone.
Patients that are exhibiting obvious signs of exposure (SLUDGEM) of organophosphate exposure and/or nerve agents
Maintain airway and position of comfort
Administer oxygen as indicated
* Mark I or DuoDote Antidote Kit
o Mild Exposure: IM x 1
o Moderate Exposure: IM x1
* May repeat in 10 minutes if symptoms persist
o Severe Exposure: IM x 3 in rapid succession, rotating injection sites
Overdose
Decontaminate if indicated and appropriate
Administer oxygen and support ventilations as indicated
Suspected opioid overdose with respirations less than 12/min and significant ALOC:
* Naloxone
o IN – 4 mg in 0.1 mL, may repeat X 1, Max of 8 mg
o IM – 2 mg, may repeat X 1, Max of 4 mg
Seizures
Protect from injury
Maintain/manage airway as indicated
Administer oxygen as indicated for suspected febrile seizures, begin passive cooling measures. If seizure activity persists, see below:
Determine Blood Glucose level, and treat according to VC EMS policy 705.03 – Altered Neurologic Function
Shortness of Breath – Pulmonary Edema
Administer oxygen as indicated
Initiate CPAP for moderate to severe distress
Shortness of Breath – Wheezes/Other
Administer oxygen as indicated
Initiate CPAP for both moderate and severe distress – 8 years of age and older
Assist patient with prescribed Metered Dose Inhaler if available
Severe Distress Only
* Epinephrine 1 mg/mL
o If Under 30 kg
* IM 0.15 mg
May repeat x1 in 5 minutes if patient still in distress
o If 30 kg and Over
* IM – 0.3 mg
May repeat x 1 in 5 minutes if patient still in distress
Suspected Stroke
Cincinnati Stroke Scale (CSS)
Administer oxygen as indicated
Administer oxygen if SpO2 less than 94% or unknown
Determine Blood Glucose level, treat according to VC EMS policy 705.03 – Altered Neurologic Function
Safely Surrendered Babies
POLICY: Emergency Medical Services (EMS) personnel shall follow the procedures outlined in this document to ensure the surrendered infant is protected and medically cared for until delivered to the closest hospital emergency department.
IV. PROCEDURE:
A. When an infant is surrendered to a fire station, the personnel shall notify their dispatch center of the situation.
B. The dispatch center will dispatch the closest paramedic transport unit.
C. Fire station personnel will assess the newborn and treat as needed.
D. Initiate first responder form.
E. Open the Newborn Safe Surrender Kit, (available at the fire station).
F. Place a confidential coded bracelet on the infant’s ankle and wrist. (Record this number on the first responder form)G. Provide the surrendering party the inner business reply mail envelope. This envelope contains the Safe Haven medical questionnaire (English and Spanish version), an information sheet, and a matching coded, confidential bracelet. Advise the surrendering party, providing there has been no abuse or neglect, the parent may reclaim the infant within 14 days, by taking the bracelet back to the hospital. Hospital personnel will provide information about the baby.
H. Upon arrival of the transport paramedic unit, the fire station personnel will provide a copy of the written report and a verbal report of the infants’ care and status.
I. If the infant appears to be greater than 72 hours old, abused or neglected, accept the infant and provide medical treatment as necessary.
J. The paramedic transport unit will initiate base station contact and begin transport to the closest appropriate hospital emergency department.
K. The paramedic transport unit will initiate care and treat the infant as needed.
L. The paramedic transport unit will complete a PCR via approved Ventura County Documentation System and will record the confidential coded bracelet number.
M. Upon arrival at the receiving emergency department, the transporting paramedic will provide a verbal and written report.
N. Receiving hospital personnel will make verbal and written notification to the Ventura County HSA Department of Children and Family Services (DCFS).
