Quick Call notes

Question 0

Anaphylaxis

Answer 0

O2 / Remove Stinger
EPI IM - 0.3mg
Benadryl - 50mg IV/IM
ECG SPO2
Albuterol - 2.5mg 
CPAP 
EPI - IV - 0.1mg IV slow slow push

Question 1

Allergic reaction

Answer 1

Remove Sting/injection site

Benadryl

Question 2

Abdominal Pain

Answer 2

Determine if hemodynamic stability / respiratory / Mentation/ AAA.
or pulse greater then 120 with hypo-perfusion.
-IV
Severe pain morphine
ECG for upper abd pain

Question 3

Dystonic

Answer 3

IV

Benadryl - 50mg IV preferred or IM

Question 4

General OD

Answer 4

IV
ECG / SPO2
Gag or unable to protect airway - decreased sensorium

Question 5

Beta Blocker OD

Answer 5

IV 
Fluid Challenge - 500 ml
Atropine - 1mg
Glucagon - 2u
Epi IV - 0.1 mg iv

*key- SBP <70

Question 6

Calcium Channel Blocker OD

Answer 6

IV
Fluid - 500ml
Atropine - 1mg IV
Epi IV - 0.1mg IVP - slow

Question 7

TCA

Answer 7

IV
Fluid - 500ml
Sodium Bicarb - 1mlEq/kg

• *key to running protocol**
• HR >120
• QRS>.12
• PVC >6/min
• SBP <90
• seizure

Question 8

Shock

Answer 8

Large Bore IV

ECG

Question 9

Stroke

Answer 9

Advanced airway as needed
BGL 
ECG 
Cincinnatti 
IV TKO 
Determine Onset < 4 hrs Go to stroke center.

Question 10

Discomfort/pain of suspected cardiac origin -

1st rule out other causes

Answer 10

Pulse OX
ECG
Nitro 0.4mg SL (SBP >90) R-5min…titrate to pain relief. (make sure no use of PDE-5 inhibitors)….if so use morphine first 2mg

ASA 324mg (4 chewable)

IV/12 lead

Cath Lab

….if after 3rd nitro no relief of pain…paramedic may admin Morphine.

Question 11

SVT - Narrow Stable

Answer 11

12 lead
Valsalva 
Adenosine 6mg
Adenosine 12mg 
Transport

Question 12

SVT Wide - Stable

Answer 12

12 lead

Transport

Question 13

SVT - Stable - Irregular

Answer 13

12 lead

transport

Question 14

SVT Unstable Narrow

Answer 14

Versed - 2mg IM/IN or 1-6mg iv
Cardiovert- 100-200-360

If stable tx-

if unstable…Cardiovert max dose- then tx

Question 15

SVT unstable Wide complex

Answer 15

Versed - IV 1-6, or 2mg IM/IN r-5 x 2
Cardiovert -100/200/360

Stable - Amiodarone 150mg/10min

Unstable -
150mg IVP
Cardiovert max dose

Question 16

Adult Bradycardia

• 3 criteria
• algorithm

Answer 16

• SBP<50, S/S Hypoperfusion
• IV / 12 lead

If type 2 2degree or 3rd straight to cardioversion
-if not atropine 0.5mg

TCP - Medicate with Versed ( 2mg IM/IN, 1-6 IV)
- start @ 80bpm and up milliamps until capture.

No TCP - Atropine 0.5 mg - 1mg IV/IO every 3-5min until 3mg given

If neither are helping move to Dopamine ( must still meet brady criteria)

• Get base hospital orders
• 10mcg/kg/min

Avoid Atropine in acute mI

Question 17

Asthma/ COPD

• mild wheezing
• sob
• cough

Answer 17

ECG/O2/Pulse ox

Albuterol 2.5-5mg prn

Question 18

Asthma/COPD

• Cyanosis
• Accessory muscle use
• Inability to speak more then 3 words
• Severe wheezing or SOB

Answer 18

ECG/ O2/ SPO2

Albuterol 5mg 
CPAP 
IV
EPI - 0.3mg IM 
***must get base order if older than 40 or SBP <180

Question 19

CHF vs COPD

Answer 19

• Med List
• JVD
• Peripheral Edema
• Frothy pink sputum
• BP
• Smoker

Question 20

CHF/Pulmonary Edema

• mild wheezing
• SOB
• cough

Answer 20

• wheezing*
• Albuterol 2.5-5mg

-Nitro 0.4mg if SBP>90, q5 *NO PED5**

IV

Question 21

CHF/Pulmonary Edema

• Cyanosis
• Accessory muscle use
• Inability to speak >3words/min
• Rales Ronchi JVD
• Diaphoresis pedal edema

Answer 21

Albuterol 2.5-5mg if wheezing

Nitro BP - *No PED 5 * - q5
90-150 - 0.4mg
150-200 - 0.8mg
200+ = 1.2mg

CPAP

• 1” Nitro Paste
• Remove paste if SBP 90

If SBP continuously below 90 consider Dopamine with base contact - 10mcg/kg/min

Question 22

ALOC

• 3 Protocols
• Other Factors

Answer 22

Hypoglycemia
Narcotic Overdose
Seizure

Question 23

ALOC - Suspected Diabetic

• Reasons to suspect
• protocol

Answer 23

GCS<60

PO- Oral glucose - Juice - must first test gag with water
IV Access - 25gm of 50% dextrose
Glucagon- 1U Im

Consider IO access if no response to Glucagon after 5min

ECG

Tx