Cardiogenic History: Signs/Symptoms: Differential: Cardiac ischemia (MI, CHF) Restlessness, confusion Dysrhythmias Medications Weakness, dizziness Vasovagal Allergic reaction Weak, pulse Pale, cook, clammy skin Delayed capillary refill Hypotension Rates & pulmonary edema on exam Legend EMT A EMT-A A P EMT-P P Adult Bradycardia M MC M (With Pulse) Legend EMT A EMT-A A A Obtain IV Access A P EMT-P P M MC Order M A A Fluid Bolus NS 12 lead ECG P P Dopamine P Or P Epinephrine M M Contact Medical Control Pearls: Meds: Be cautious of impending pulmonary Dopamine 5 20 mcg/kg/prn titrate – Hypotension can be defined as systolic blood pressure of less than 100 SBP>100 Consider performing orthostatic vital signs on patients in nontrauma Epinephrine mix 1mg 1:1000 in 250 NS situations if suspected blood or fluid loss titrate to SBP>100 drip 2-10 mcg/min fluid bolus and reevaluate lung sounds
Cardiogenic History: Cardiac ischemia (MI, CHF) Medications Allergic reaction Signs/Symptoms: Restlessness, confusion Weakness, dizziness Weak, pulse Pale, cook, clammy skin Delayed capillary refill Hypotension Rates & pulmonary edema on exam Differential: Dysrhythmias Vasovagal Pearls: Be cautious of impending pulmonary Hypotension can be defined as systolic blood pressure of less than 100 Consider performing orthostatic vital signs on patients in nontrauma situations if suspected blood or fluid loss fluid bolus and reevaluate lung sounds Meds: Dopamine 5 – 20 mcg/kg/prn titrate SBP>100 Epinephrine mix 1mg 1:1000 in 250 NS titrate to SBP>100 drip 2-10 mcg/min Legend EMT A EMT-A A P EMT-P P M MC M A Obtain IV Access A A Fluid Bolus NS A P 12 lead ECG P P Dopamine Or Epinephrine P M Contact Medical Control M Adult Bradycardia Legend EMT A EMT-A A P EMT-P P M MC Order M (With Pulse)
2012_lc_ems_protocols.docx