Patient Care Treatment Protocol · Web viewManagement of Preeclam p sia or Eclampsia History Due...
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Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYN OB/GYN: Preeclampsia and Eclampsia - 7080 PREECLAMPSIA AND ECLAMPSIA Prehospital Management of Preeclampsia or Eclampsia History Due date, prenatal care Sensation of fetal activity Past medical and delivery history Medications, Allergies Gravida/Para Status High Risk pregnancy Shortness of breath Signs and Symptoms Seizures (type and length) Hypertension Severe Headache, photophobia Visual changes Edema of hands and face Hyperreflexia Pulmonary edema Tachycardia, dysrhythmias ASSESSMENT Preeclampsia/ Eclampsia TREATMENT GUIDELINES R-EMR E-EMT A-EMTA P-PARAMEDIC **M-Medical Control ** ***Higher level of providers are responsible for lower level treatments*** Initial Patient Contact (2000). Oxygen Administration (9000). Position patient in left lateral recumbent position. Create a low stimulus environment. R Pulse Oximetry (9001). Transport to appropriate facility with ALS intercept. E Establish IV with NS, draw labs; do not delay transport for IV access. 2 If patient is stable, run IV at KVO. 2 Monitor for Respiratory Distress (4002). Blood Glucose Analysis (9040) if patient has had seizures or ALOC (7000). 2 For glucose <60 and patent IV, administer 12.5-25 gm of 50% Dextrose IV. For glucose <60 and no IV, administer 1unit (1 mg) Glucagon IM. A ALS required for signs of preeclampsia or eclampsia. Repeat patient assessment. Administer Magnesium Sulfate IV 4 grams over 15 minutes (loading dose) then further doses only per Medical Control. Maintenance infusion: 5 grams/250 cc and run at 100 cc/hr (2 grams/hr). For active or recurrent seizures administer 0.05 to 0.1 mg/kg P ________________________________________________________________________________________________________________ _______________________ BCEMS Medical Director Effective: 04/01/14 final 2/25/2022 page 1 of 2
Transcript of Patient Care Treatment Protocol · Web viewManagement of Preeclam p sia or Eclampsia History Due...
Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYNOB/GYN: Preeclampsia and Eclampsia - 7080
PREECLAMPSIA AND ECLAMPSIA
Prehospital Management of Preeclampsia or EclampsiaHistory
Due date, prenatal care Sensation of fetal activity Past medical and delivery history Medications, Allergies Gravida/Para Status High Risk pregnancy Shortness of breath
Signs and Symptoms Seizures (type and length) Hypertension Severe Headache, photophobia Visual changes Edema of hands and face Hyperreflexia Pulmonary edema Tachycardia, dysrhythmias
ASSESSMENT Preeclampsia/ Eclampsia
TREATMENT GUIDELINESR-EMR E-EMT A-EMTA P-PARAMEDIC **M-Medical Control
*****Higher level of providers are responsible for lower level treatments***
Initial Patient Contact (2000). Oxygen Administration (9000). Position patient in left lateral recumbent position. Create a low stimulus environment. R Pulse Oximetry (9001). Transport to appropriate facility with ALS intercept. E Establish IV with NS, draw labs; do not delay transport for IV access.2
If patient is stable, run IV at KVO.2
Monitor for Respiratory Distress (4002). Blood Glucose Analysis (9040) if patient has had seizures or ALOC (7000).2
For glucose <60 and patent IV, administer 12.5-25 gm of 50% Dextrose IV. For glucose <60 and no IV, administer 1unit (1 mg) Glucagon IM.
A
ALS required for signs of preeclampsia or eclampsia. Repeat patient assessment. Administer Magnesium Sulfate IV 4 grams over 15 minutes (loading dose) then
further doses only per Medical Control. Maintenance infusion: 5 grams/250 cc and run at 100 cc/hr (2 grams/hr). For active or recurrent seizures administer 0.05 to 0.1 mg/kg Midazolam IV/IN/IM
(maximal single dose 2.5 mg; may repeat q 5 min x 2 for ongoing seizures.
P ** Call Medical Control for all eclampsia patients**. M2EMT providers may perform these procedures if credentialed with the appropriate OM.Pearls:PREECLAMPSIA is characterized by maternal hypertension, visual disturbances, headache and edema.ECLAMPSIA occurs when a woman with Preeclampsia has a seizure.Hypertension is defined as a BP greater than 140 systolic or greater than 90 diastolic, or a relative increase of 30 systolic and 20 diastolic from the pre-pregnancy blood pressure.Magnesium may cause hypotension and decreased respiratory drive; use with caution. Do not give faster than 1 gram/minute.QA: 100% review of patients requiring IV Magnesium Sulfate.
_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/9/2023 page 1 of 1
