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2008 Mercy Protocols Changes

Page 7 Aeromedical HelicopterChanges in Landing Zone requirements and Aeromedical Use Guidelines.

Page 13 NOTIFICATION OF SPECIAL PROCEDURESChanges in notification items and updates contact info.

Page 17 Cardiac A CARDIAC ARREST PROTOCOLCPR Changes, and New Defib energy levels for various types of defibrillators.

Page 19 Cardiac B-VENTRICULAR FIBRILLATIONNew ACLS Protocol with Vassopressin first and ResQ Pod. Newer ET Meds list. If pt

down time greater than 4 minutes do CPR for 2 minutes then first DEFIB.

Page 21 Cardiac C- Pulseless Electrical ActivityChanges in ACLS Protocol, Vassopressin first (is identical to asystole protocol)

Page 23 Cardiac D AsystoleChanges in ACLS Protocol, Vassopressin first, No pacing (is identical to PEA

protocol)

Page 26 Cardiac G- BRADYCARDIA PROTOCOLEpi drip changes to correct math error, Atropine max 3mg, sedation changes,

Page 28 Cardiac H Third degree blockEpi drip changes to correct math error, Atropine max 3mg, sedation changes,

Page 30 Cardiac G- PSVTAdenosine 6mg then 12mg then move to Cardiazem if narrow and amiodarone if

wide complex. Sedation changes

Page 34 Cardiac N-1, ACUTE CORONARY SYNDROMEFour 81mg Aspirin, Morphine and Fentanyl dosage changes. EMT Intermediates

May use Nitro SL, Nitro drips for approved sites with infusion pumps

Page 35 Cardiac O Acute Pulmonary EdemaFour 81mg Aspirin, Morphine and Fentanyl dosage changes. EMT Intermediates May

use Nitro SL, Nitro drips for approved sites with infusion pumps. Lasix dose reduced

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Page 41-44 Medication Infusion ProtocolsChanges for Nitro drips, add natrecor, epi dopamine cardiazem drips ok for

interfacility transports. Concentrations at Mercy Pump standards. Exclusion list

denoted. This is for Lifestar Interfacility transports mostly.

PAGE 57-58 Medical Emergencies A Altered mental StatesEMT Intermediates May use Benedryl, Narcan, Glucagon, D50

Blood sugar < 60 mg/dl or if blood sugar < 80 mg/dl and patient has signs and symptoms of If

hypoglycemia, administer one amp 50 ml of 50% Dextrose IV push

If no IV can be established administer 1 unit Glucagon IM.

****Above May be given by Authorized EMT-Intermediates****

PAGE 59-60 Medical Emergencies a-1 PoisoningsEMT Intermediates May use Benedryl, Narcan, Glucagon, D50

PAGE 61-64 Medical Emergencies C SEIZURES, SYNCOPEEMT Intermediates May use Glucagon, D50

PAGE 65-67 Medical Emergencies E Asthma and F Allergic

ReactionsEMT Intermediates may use Epi, Benedryl, Aeresols

PAGE 68 Medical Emergencies G CVAEMT Intermediates May use Glucagon, D50

PAGE 70 Medical Emergencies I Abdominal Pain

Phenergan deleted, Zofran added/ COMPAZINE ,

PAGE 71 Medical Emergencies J Cyanide PoisoningHydroxycobalamin (Cyanakit) added, amyl nitrate limited, sodium thiosulphate

deleted

PAGE 72-73 Medical Emergencies K-2 Hypertensive crisisLopressor one dose without med control order.

PAGE 76 Medical Emergencies I VOMITINGPhenergan deleted, Zofran added/ COMPAZINE ,

PAGE 77 Medical Emergencies COPD.Intermediates can give aerosols

For third aerosol may be given, mix 1unit dose of Albuterol and 1 unit dose of

Atrovent

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PAGE 80-81 PEDS RESP DISTRESS .Intermediates can give aerosols

PAGE 82 PEDS ASTHMA .Intermediates can give aerosols

PAGE 83 PEDS ALLERGIC Allergic ReactionsEMT Intermediates may use Epi, Benedryl, Aeresols

PAGE 99 PEDS SEIZURESEMT Intermediates May use Glucagon, D50

PAGE 100 PEDS POISONSEMT Intermediates May use NARCAN Glucagon, D50

PAGE 115 TRAUMA EXT TRAUMA

PAIN meds changes to include IN new dosages Fentanyl Morphine

PAGE 117 TRAUMA BurnPAIN meds changes to include IN new dosages Fentanyl Morphine

PAGE 123 HyperthermiaEMT Intermediates May use Glucagon, D50

PAGE 131 Procedures RSINew dosages meds

PAGE 138 Procedures Needle decompressionCorrect placement 4th 5th intercostal space. EMT I allowed

PAGE 142 Procedures I/OPolicy revised Fast 1, EZ IO

PAGE 145 Procedures Alternate IV UsePolicy revised need chlorohexadine swabs, saline locks allowed.. get pre-filled

saline syringes

PAGE 153 Procedures resqpodPolicy revised

PAGE 154 Procedures Fast 1Policy revised

Need to develop KING LT procedure

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Communications Failure........................................................................................

............4

Transport Procedures ..........

....................................................................................... 4

Appropriate Facility............................................

.......................................................5

Control of EMS at the Scene ........................................................

6

Activation of Life Flight ............................................

....................................................... 7

Refusal of Treatment or Transport ......................................

...................................................... 9

Medical Legal .........................................

................................................................10

Communication Procedure....

12

Notification of Special Procedures ...

.. . 13

LCEMS Hospital By-pass

.

14

Cardiac Arrest Protocol

17

Ventricular Fibrillation

.19

PEA (Pulseless Electrical Activity)

........21

Asystole

..23

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Trauma Cardiac Arrest

.24

Hypothermic Cardiac Arrest

.25

Bradycardia

..26

Third Degree Heart Block

28

Unstable Tachycardia

..29

Paroxysmal Supraventricular Tachycardia (PSVT)

.30

Ventricular Tachycardia

..31

Wide Complex Tachycardia of Uncertain Type32

Cardiogenic Shock

33

Acute Coronary Syndrome

34

Acute Pulmonary Edema

35

Premature Ventricular Contractions (PVCs/VPBs)

.36

Automatic Implantable Cardiac Defibrillator (AICD)

.37

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12-Lead ECG Protocols...

..38

Medication Infusion

Protocols

.41

CPR Protocol

47

Cessation of CPR

..49

DOA Policy

50

DNR Comfort Care Policy

52

Altered Mental States

..........57

Poisons and Overdose

..59

Seizures

..61

Syncope

..63

Asthma

65

Allergy/Anaphylaxis

.66

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CVA

.68

Abdominal Pain

.70

Cyanide Poisoning

71

Hypertension

..72

Shock: (Medical)

..74

Vaginal

Bleeding

.75

Vomiting & Diarrhea

..76

COPD

77

Respiratory / Obstruction

..80

Asthma

82

Allergy/Anaphylaxis

83

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Cardiac Arrest Protocol

85

Ventricular Fibrillation

.88

PEA (Pulseless Electrical Activity)

..89

Asystole

..90

Trauma Cardiac Arrest

.91

Hypothermic Cardiac

Arrest

..92

Bradycardia

..93

Symptomatic

Tachycardia94

Deliveries and Neonatal Resuscitation

.95

APGAR scale / Inverted Pyramid

..97

Pediatric Tables

.98

Seizures

..99

Poisons and Overdose (Unconscious Unknown)

..100

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General Trauma Protocol

104

Trauma Death ..

.108

Amputated Part

.109

Multi System Trauma Patient

.1

10

Load and Go Situations ..

114

Extremity Trauma

.

...115

Eye Injuries .

....116

Burns

..117

Drowning and Near Drowning .......................................

...120

Hypothermia and Frostbite..

..121

Hyperthermia

123

Haz

mat

.124

Selective C-spine .

.127

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Rapid Sequence

Intubation

.131

Intubation

.133

Nasotracheal

Intubation

137

Needle

Decompression

..138

Cricothyrotomy

139

Nebulizer

..140

Pulse

Oximeter

.141

Intraosseous

Needle

.142

ShockPants

.143

Restraint

Policy

..144

Alternate IV

Access..................................

...................145

Auto Vent

2000

146

Laryngeal Mask Airway ......

148

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CPAP (Continuous Positive Airway Pressure)

151

ResQPod.

..........................................................

.. 153

F.A.ST. 1.

..........................................................

...... 154

Use of Prescribed Albuterol Inhaler .

157

Epinephrine Auto-Injector ...

.158

Blood Glucose Meter

.159

Administration of

Aspirin...............................................

.........160

Advanced EMTs IV

Starts

..161