Airway, Adult Failed Reactive Airway Disease Legend EMT History: and Symptoms: Differential: A EMT-A A Asthma Shortness of breath Asthma P EMT-P P COPD Emphysema, chronic Bronchitis Pursed-lip breathing Anaphylaxis – M MC Order M Congestive Heart Failure Decreased ability to speak Aspiration Home treatment (0₂, nebulizer) Increased respiratory rate and effort COPD (Emphysema, Bronchitis) Medications, (Theophylline, Steroids, Wheezing, rhonchi Pleural effusion Inhalers) Use of accessory muscles Pneumonia Toxic exposure Fever, cough Pulmonary Embolus Smoking Tachycardia Pneumothorax Continue BVM Cardiac (MI or CHF) Pericardial Tamponade Hyperventilation Inhaled Toxin (Carbon monoxide, etc.) Pulse Oximetry Pulse Oximetry Universal Patient Care Protocol Legend EMT A EMT-A A Pt’s MDI per prescription P EMT-P P Combitube/ M MC Order M King-LTD Contact M Medical Combitube/ A ontrol King-LTD Obtain IV access A M Oral-tracheal A Obtain IV access A Febrile or P Hypotensive? Yes P Surgical Airway P P ― Intubation P ECG P A Albuterol prn A And prn p p Atrovent Notes: For this protocol, adult is defined any person who does not fit the ● Broselow-Luten tape EMT’s must have multi-lumen airway training to use Combitubes or ● King-LTD Capnometry or Capnography is mandatory with all methods of ● intubation. Document result. Maintain immobilization for patients with suspected spinal ● injury Paramedics should consider combitube or King-LTD when unable to ● p Epinephrine p intubate p Methylprednisolone prn p Reconfirm ETT placement each time patient is ● Continuous oximetry should be utilized in all patients with compromised respiratory function ●
Notes: ● For this protocol, adult is defined any person who does not fit the Broselow-Luten tape ● EMT’s must have multi-lumen airway training to use Combitubes or King-LTD ● Capnometry or Capnography is mandatory with all methods of intubation. Document result. ● Maintain immobilization for patients with suspected spinal injury ● Paramedics should consider combitube or King-LTD when unable to intubate ● Reconfirm ETT placement each time patient is ● Continuous oximetry should be utilized in all patients with compromised respiratory function Pulse Oximetry Pulse Oximetry M Contact Medical ontrol M Combitube/ King-LTD P Oral-tracheal Intubation P Airway, Adult Failed Continue BVM Legend EMT A EMT-A A P EMT-P P M MC Order M P Surgical Airway P Combitube/ King-LTD Reactive Airway Disease History: Asthma COPD – Emphysema, chronic Bronchitis Congestive Heart Failure Home treatment (0₂, nebulizer) Medications, (Theophylline, Steroids, Inhalers) Toxic exposure Smoking and Symptoms: Shortness of breath Pursed-lip breathing Decreased ability to speak Increased respiratory rate and effort Wheezing, rhonchi Use of accessory muscles Fever, cough Tachycardia Differential: Asthma Anaphylaxis Aspiration COPD (Emphysema, Bronchitis) Pleural effusion Pneumonia Pulmonary Embolus Pneumothorax Cardiac (MI or CHF) Pericardial Tamponade Hyperventilation Inhaled Toxin (Carbon monoxide, etc.) Universal Patient Care Protocol Legend EMT A EMT-A A P EMT-P P M MC Order M Pt’s MDI per prescription A Obtain IV access A Febrile or Hypotensive? ― Yes A Obtain IV access A P ECG P A Albuterol prn A p And prn Atrovent p p Methylprednisolone prn p p Epinephrine p
2012_lc_ems_protocols.docx