RivCoEMS Protocols 2020

Question 1

Ketamine Dose IVPB

Answer 1

0.3mg/kg over 5 min w/ NS- max single dose of 30 mg

Question 2

Ketamine Dose IN

Answer 2

0.5 mg/kg to max single dose of 30 mg

Question 3

Magnesium Sulfate dose: Preeclampsia/eclampsia

Answer 3

IVPB: 5g in 50mL over 10 min
IM: 2.5g x 2

Question 4

Pain Management: Fentanyl

Answer 4

50mcg MR x 1 w/ SBP >90mmHg

For pain associated with acute abdominal/ flank pain, sickle cell crisis, cancer pain, acute traumatic injury or injuries, burns, or cold injuries.

Question 5

Pain Management: Ketamine

Answer 5

Max single dose of 30mg MR x 1

For pain associated with acute abdominal/ flank pain, sickle cell crisis, cancer pain, acute traumatic injury or injuries, burns, or cold injuries.

Question 6

Tranexamic Acid

Answer 6

1g IVPB in 50-100mL NS over 10 min MR BHO

For injuries within 3 hours: s/s hemorrhagic shock

• SBP < 90mmHg
• HR > 120 bpm
• Uncontrolled bleeding despite tourniquet application

Question 7

Discontinue Resuscitation:

Answer 7

Medical Cardiac Arrest w/o ROSC and minimum 20 HP CPR w/ following

• IV/IO established
• Airway appropriately controlled
• Rhythm appropriate meds and defib administered w/o ROSC.
• Persistent (>20 min) asystole or agonal rhythm w/o ROSC.
• Patient’s rhythm is not refractory VF or VT
• Failure to establish circulation at any point in the arrest.

Question 8

Traumatic Arrest transport decision

Answer 8

Blunt Trauma Arrest: Closest Receiving

Penetrating: Closest trauma w/ signs of life (pupillary response, VF/VT, spontaneous breathing)

Question 9

Traumatic Arrest: withhold resuscitation

Answer 9

Persistent asystole, agonal rhythm, PEA < 40 bpm with no signs of life.

Question 10

Push Dose Epinephrine

Answer 10

0.01 mg IV MR PRN Q 1-5 minutes
(mix 1mL of 0.1mg/mL w/ 9mL of NS)

For shock unrelated to trauma; post 250mL of NS