Foreign Body Airway Obstruction Cardiac Arrest Medical Directive

Question 1

Foreign Body Airway Obstruction Cardiac Arrest Medical Directive

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized.

Question 2

Indications

Answer 2

Cardiac arrest secondary to an airway obstruction.

Question 3

Conditions - CPR

Answer 3

Age: N/A
LOA: Altered
HR: N/A
RR: N/A
SBP: N/A
Other: Performed in 2 minute intervals

Question 4

Conditions - Manual Defibrillation

Answer 4

Age: ≥30 days
LOA: Altered
HR: N/A
RR: N/A
SBP: N/A
Other: VF OR pulseless VT

Question 5

Conditions - AED Defibrillation

Answer 5

Age: ≥30 days
LOA: Altered
HR: N/A
RR: N/A
SBP: N/A
Other: Defibrillation indicated

Question 6

Contraindications - CPR

Answer 6

Obviously dead as per BLS PCS

Meets conditions of Do Not Resuscitate (DNR) Standard

Question 7

Contraindications - Manual Defibrillation

Answer 7

Rhythms other than VF or pulseless VT

Question 8

Contraindications - AED Defibrillation

Answer 8

Non-shockable rhythm

Question 9

Treatment

Answer 9

Consider CPR
Consider foreign body removal (utilizing BLS PCS maneuvers)
Consider Manual defibrillation (if available and authorized)
Consider AED defibrillation (if not using manual defibrillation)

Question 10

Consider Manual defibrillation (if available and authorized)

Answer 10

Age ≥30 days to <8 years:
Dose: 1 defibrillation
Initial dose: 2 J/kg
Dosing interval: N/A
Max. # of doses: 1

Age ≥8 years:
Dose: 1 defibrillation
Initial dose: As per BH/manufacturer
Dosing interval: N/A
Max. # of doses: 1

Question 11

Consider AED defibrillation (if not using manual defibrillation)

Answer 11

Age ≥30 days to <8 years:
With Pediatric Attenuator Cable:
Dose: 1 defibrillation
Max. single dose: As per BH/manufacturer
Dosing interval: N/A
Max. # of doses: 1
Without Pediatric Attenuator Cable:
Dose: 1 defibrillation
Max. single dose: As per BH/manufacturer
Dosing interval: N/A
Max. # of doses: 1

Age ≥8 years:
Dose: 1 defibrillation
Max. single dose: As per BH/manufacturer
Dosing interval: N/A
Max. # of doses: 1

Question 12

Clinical Considerations

Answer 12

If the patient is in cardiac arrest following removal of the obstruction, initiate management as a medical cardiac arrest.
If the obstruction cannot be removed, transport to the closest appropriate facility without delay following the 1st analysis.