M Contact Medical Control M Notes: Meds: Individual’s normal body temperature differ with Acetaminophen- 500-1000mg PO 98.6°F (37°C) being average. Generally a Diphenhydramine- 25-50 mg IV/IM/PO Zofran- 4mg / 2ml IV/IM temperature over 100°F (38°C) is considered a fever. If shivering or hyperthermic give Lorazepam *If indicated **Contact Medical Control Overdose/Poisoning History: Signs / Symptoms: Differential: · Ingestion or suspected ingestion of a potentially ·Mental status changes · Tricyclic antidepressants (TCAs) toxic substance · Hypotension / Hypertension · Acetaminophen (Tylenol) · Substance ingested, route, quantity · Decreased respiratory rate · Depressants · Time of ingestion Tachycardia, dysrhythmias · Stimulants ∙ · Reason (Suicidal, accidental, criminal) Seizures · Anticholinergic ∙ · Past medical history, medications · Cardiac medications · Solvents, Alcohol, Cleaning agents Poison Control 800-222-1222 · Insecticides (organophosphates) Universal Patient Care Protocol Legend <60 mg/dl EMT A EMT-A A Above 60 mg/dl P EMT-P P M MC Order M Glucose Gel Obtain IV Access A A No Yes Dextrose prn A A Obtain IV Access A A Contact Medical Control M M With nature of toxic exposure Respiratory depression? A A Naloxone PRN Opiates Tricyclic Calcium Channel Blockers Beta Blockers Organophosphates CNS Stimulants Sodium Lorazepam P P P Calcium PRN P P P P or Chloride Excess Naloxone A Midazolam A P Airway Secretions? Atropine Consider TCP P P Dopamine P P Dopamine P P Glucagon P P Pearls: Meds: Do not rely on patient history of Atropine 2mg IVP q 5-15 min. Max 20 mg ingestion, especially in suicide Calcium Chloride- 500-1000 mg IV-Slowly attempts. Dextrose- 25-50 g IV PRN
M Contact Medical Control M Notes: Individual’s normal body temperature differ with 98.6°F (37°C) being average. Generally a temperature over 100°F (38°C) is considered a fever. If shivering or hyperthermic give Lorazepam *If indicated **Contact Medical Control Meds: Acetaminophen- 500-1000mg PO Diphenhydramine- 25-50 mg IV/IM/PO Zofran- 4mg / 2ml IV/IM Overdose/Poisoning History: · Ingestion or suspected ingestion of a potentially toxic substance · Substance ingested, route, quantity · Time of ingestion · Reason (Suicidal, accidental, criminal) · Past medical history, medications Signs / Symptoms: ·Mental status changes · Hypotension / Hypertension · Decreased respiratory rate ∙ Tachycardia, dysrhythmias ∙ Seizures Differential: · Tricyclic antidepressants (TCAs) · Acetaminophen (Tylenol) · Depressants · Stimulants · Anticholinergic · Cardiac medications · Solvents, Alcohol, Cleaning agents · Insecticides (organophosphates) Poison Control 800-222-1222 Universal Patient Care Protocol Legend EMT A EMT-A A P EMT-P P M MC Order M <60 mg/dl Glucose Gel A Obtain IV Access A A Dextrose prn A Above 60 mg/dl No Yes A Obtain IV Access A M Contact Medical Control With nature of toxic exposure M A Respiratory depression? Naloxone PRN A Opiates Tricyclic Calcium Channel Blockers Beta Blockers Organophosphates CNS Stimulants P PRN Excess Airway Secretions? Atropine P P Sodium P P Calcium Chloride P P Lorazepam or Midazolam P A Naloxone A P Consider TCP P P Dopamine P P Dopamine P P Glucagon P Pearls: Do not rely on patient history of ingestion, especially in suicide attempts. Meds: Atropine 2mg IVP q 5-15 min. Max 20 mg Calcium Chloride- 500-1000 mg IV-Slowly Dextrose- 25-50 g IV PRN
ems_protocols.3.21a.docx