November 2024 Protocol Update

Question 1

Non Tramatic Cardiac Arrest - - Where Shall you transport any pt that is in a shockable rhythm at any point during resusitation.

Answer 1

Time closests Stemi facility

Question 2

ROSC End Title CO2 goal

Answer 2

35-45

Question 3

Shock Post Arrest Treatment - <90mmhg

Answer 3

1000ml fluid bolus
w/ Concurrent push dose epi
.01mg/ml (10mcg/ml) - Dose .5-2ml every 2 - 5 minutes (5-20mcg)
-Reassess vitals after each dose

Question 4

Push Dose Epi Dose

Answer 4

.01mg/ml (10mcg/ml) - Dose .5-2ml every 2 - 5 minutes (5-20mcg)
-Reassess vitals after each dose

Question 5

New Max Dose For Epi

Answer 5

3mg

Question 6

Non tramatic cardiac Arrest - How long to get 12 lead after ROSC

Answer 6

7 min - prior to transport

Question 7

You obtain ROSC post arrest how long should you stay on scene?

Answer 7

10 minutes - studies show better outcomes staying on scene. May start new round of EPI if rhythm changes

Question 8

TXA Inclusion Criteria

Answer 8

Blunt or penetraing trauma with SBP <90 AND signs of hemorrhagic shock

Question 9

TXA Exclusion Criteria

Answer 9

> 3 hours , isolated neck or extremity, PE last 24 hours, Arrest with >5min of CPR without ROSC, Hypotension secondary to spinal cord injury with motor deficit, Pedi < or equal to 14, Head injury with GCS <9 OR unreactive pupils.

Question 10

TXA Dosage

Answer 10

2 gm TXA slow IV/IO over 1 minute
2gm of TXA requires 2 vials drawn up in a 20cc syringe

Question 11

Topical TXA indications

Answer 11

Bleeding from epistaxis, lacerations, or oral bleeding

Question 12

Dosage for Topical TXA

Answer 12

1gm TXA soaked into gauze pad adn applied with direct pressure x10 min

Question 13

Pediatric perfered IO sites

Answer 13

Proximal Tibia
Distal Tibia
Distal Femur