p Magnesium p M M Contact Medical Control Pearls: Meds: Barotrauma is often caused by the over-ventilation of Reactive Albuterol- 2.5 mg SVN Airway Patients Consider NIPPV if available Atrovent- 0.5 mg SVN Epinephrine- 1:1,000 0.1-03ml IM Magnesium- 2 g/100mg IV over 10-15 min Methylprednisolone- 125 mg IV Pulmonary Edema History: Signs/Symptoms: Differential: Congestive Heart Failure Respiratory distress, rales Myocardial Infarction • • • Past Medical history Apprehension, Orthopnea Congestive Heart Failure • • • Medications (Digoxin, Lasix) Jugular vein distention Asthma • • • Viagra, Levitra, Cialis Pink, frothy sputum Anaphylaxis • • • Cardiac history past Myocardial Peripheral edema, Diaphoresis Aspiration • – • • Infarction Hypotension, shock COPD • • Chest pain Pleural effusion • • Mild Moderate- able to speak sentences, crackles base only, 0₂ sat 92% Pneumonia • ≥ Pulmonary Embolus Severe- respiratory distress, crackles throughout, 0₂ sat <92% • Pericardial Tamponade Near Death- Decreased LOC, cyanosis, dropping sats, ineffective respiratory drive • Universal Patient Care Protocol Legend EMT A EMT-A A A Obtain IV Access A P EMT-P P MC M M Order P P ECG / 12 Lead P P Consider Capnography Nitroglycerin if SBP> 100 A A P And / or P Furosemide
Pearls: Barotrauma is often caused by the over-ventilation of Reactive Airway Patients Consider NIPPV if available Meds: Albuterol- 2.5 mg SVN Atrovent- 0.5 mg SVN Epinephrine- 1:1,000 0.1-03ml IM Magnesium- 2 g/100mg IV over 10-15 min Methylprednisolone- 125 mg IV p Magnesium p M Contact Medical Control M Pulmonary Edema History: • Congestive Heart Failure • Past Medical history • Medications (Digoxin, Lasix) • Viagra, Levitra, Cialis • Cardiac history – past Myocardial Infarction Signs/Symptoms: • Respiratory distress, rales • Apprehension, Orthopnea • Jugular vein distention • Pink, frothy sputum • Peripheral edema, Diaphoresis • Hypotension, shock • Chest pain Differential: • Myocardial Infarction • Congestive Heart Failure • Asthma • Anaphylaxis • Aspiration • COPD • Pleural effusion • Pneumonia • Pulmonary Embolus • Pericardial Tamponade Mild Moderate- able to speak sentences, crackles base only, 0₂ sat ≥ 92% Severe- respiratory distress, crackles throughout, 0₂ sat <92% Near Death- Decreased LOC, cyanosis, dropping sats, ineffective respiratory drive Legend EMT A EMT-A A P EMT-P P M MC Order M Universal Patient Care Protocol A Obtain IV Access A P ECG / 12 Lead P P Consider Capnography P A Nitroglycerin if SBP> 100 A P And / or Furosemide P
2012_lc_ems_protocols.docx