Universal Guidelines Flashcards
On Scene Disputes
Not mentioned in PCR.
Must contact MCP for dispute resolution.
Separate written report if dispute is unresolved.
Scene Times-General Instructions-
Kept to a minimum unless: Trauma- c-spine prior to transport.
Nontraumatic CPR is exception.
Neonate
Birth to 28 days
Pediatric
Medical: less than 37kg (81 pounds)
Trauma: under 14 years old
Adult
Medical: 37kg (81 pounds) or greater
Trauma: older than 14 years old
Interfacility Transfer
SHOULD THE PATIENT DECOMPENSATE DURING TRANSPORT, EMS PROVIDERS SHALL ASSUME ALL PRIMARY CARE RESPONSIBILITIES with assistance from accompanying staff.
Transport of Pt’s with Blood Products
If allergic reaction signs, immediately stop infusion and initiate a normal saline infusion (using new tubing). Reaction usually happens within 10ml of infusion
General Medical Treatment- B.S.I.
Mask on patient. MANDATORY TO ADD N95 OR SCBA if using CPAP, BVM, or nebulizer
ABC order. Airway
ET tube or supraglottic are advanced airways of choice. Advanced airway if GCS < 8.
ABC Order. Breathing
Rate, depth, pattern. Pulse ox to 94%. COPD to 90%
ABC Order. Circulation
LOC and mental status.
Cap refill in pedi.
Hypotension <90 adult or <70 + (2x age) pedi.
12 lead on any patient who may have cardiac cause.
Cardiac related treat in order: Rate, Rhythm, Blood Pressure
Cardiac Arrest
C.A.B.
Compressions, Airway, Breathing.
IV access, Fluids, Medications
Follow medication administration with 10-20mL bolus
LBRT
LBRT doses may be utilized in lieu of calculating pediatric doses per protocol.
Universal Care Guidelines- Trauma
Rapid transport. Patients should be approached and assessed utilizing Primary, Secondary, and Reassessment Surveys.
Primary Survey- Trauma
Rapidly identify life threatening injuries. Done within two minutes of contact. THE PRIMARY SURVEY IS ONLY INTERRUPTED FOR AIRWAY OBSTRUCTION OR CARDIAC ARREST.
STEPS: C-spine, ABC, control hemorrhage, assess AVPU scale
Secondary Survey-Trauma
Completed enroute to facility for critical or within 5 minutes of primary for noncritical.
STEPS: vitals (HR, BP, Resp, SP02), BP done manually. SAMPLE, head to toe, GCS/RTS, bandage/splint, obtain vascular access
Reassessment Survey- Trauma
Every five minutes for critical.
STEPS:
Repeat primary, repeat vitals and GCS, reassess all injuries/interventions
Fluid Therapy
Adults: 500ml NS if BP <90. May repeat once.
Pedi: per LBRT. May repeat once.
If IV access cannot be obtained after 2 attempts in 90 seconds, consider IO.
Authority for Control of Medical Services at an Emergency Scene
If pt’s Dr is on scene, follow order unless it conflicts with protocols. Contact OLMCP. Let OLMCP know about any decisions made. Keep communication open between OLMCP and on scene physician.
Disaster Response
“Disaster Response Mode”. For hurricanes, tornadoes, etc.
Crews may treat and release. Consult supervisor for life threatening situations.
Expired Medication
Use ONE YEAR after expiration date.
