Protocols

Question 1

Chest pain

Answer 1

*12 lead
*4 ASA (Aspirin) 324 mg chewed
*check for ED medication
*Nitro 0.4 mg SL q 5 min x3
*Fentanyl 25-100 mcg IV/IO (200 mcg total) or Morphine Sulfate 1-5 mg IV (10 mg)

Question 2

Allergic Reaction

Answer 2

*Epinephrine 0.3 mg 1 mg/mL IM (may repeat every 5-15 minutes)
*Albuterol 2.5 mg HHN
* Hypotensive infuse 1 literally NS IV/IO WO rate
Benadryl 25-50 mg IV/IM/PO
B-blocker persistent symptoms 1 mg glucagon IV/IM

Question 3

Asthma /COPD

Answer 3

*Albuterol 2.5 mg nebulizer or combine with Ipratropium bromide( may use duoneb)
can repeat x2 and ask medical control if more are needed.

*Multiple treatments administer 60 mg prednisone or solumedrol 125 mg IV or PO

• impending respiratory failure consider Positive pressure protocol
• if asthma , epinephrine 0.3 mg (1mg/1ml) IM followed by mag Sulfate 2 g IV/IO in 100 mL of saline

Question 4

Congestive Heart Failure

Answer 4

*consider Cpap
*determine if Ed meds were taken
*nitroglycerin 0.4 mg sl q 5 min x3 for mild symptoms.
Or 0.8 mg sl q 5 min x3 for moderate to severe symptoms