P ECG / 12 lead P M Contact Medical Control M Pearls: Meds: · Be aware of AMS as presenting sign of an environmental toxin or Haz-Mat exposure and Dextrose - D50% 25-50 g IV protect personal safety. Glucagon- 1 mg IM · It is safer to assume hypoglycemia than hyperglycemia if doubt exists. Naloxone- 0.4-2 mg IV /IM (Start with · Do not let alcohol confuse the clinical picture. Alcoholics frequently develop hypoglycemia lower dose) · Low glucose (,60), normal glucose (60 120), high glucose (>250). – · Consider Restraints if necessary for patient’s and/or personnel’s protection per the restraint procedure. General Illness Fever / Nausea / Vomiting / Unknown History: Signs / Symptoms: Differential: · Age ·Warm · Infections / Sepsis · Duration ·Sweaty · Cancer / Tumors / Lymphomas · Past medical history · Flushed · GI or Renal disorders · Last Oral Intake · Pain · Heat Stroke · Medications · Radiation · Medication or drug reaction · Immunocompromised · Abdominal distension · Vasculitis · Blood emesis/diarrhea · Chills/Rigors · Hyperthyroid · Menstrual history · Constipation · CNS disease/trauma · Environmental exposure · Diarrhea · Myocardial infarction · Diabetic ketoacidosis · Gynecologic disease (ovarian cyst, PID) · Electrolyte abnormalities · Pregnancy · Psychologic Legend Universal Patient Care Protocol EMT A EMT-A A Check Blood Glucose * P EMT-P P M MC Order M Perform Cincinnati Stroke* A Obtain IV Access A A Fluid Bolus NS prn A Test P ECG / 12 lead prn P P Zofran or Diphenhydramine P Nausea/Vomiting? No Acetaminophen P P Consider No Cooling measures Consider Lorazepam P P
P ECG / 12 lead P Pearls: · Be aware of AMS as presenting sign of an environmental toxin or Haz-Mat exposure and protect personal safety. · It is safer to assume hypoglycemia than hyperglycemia if doubt exists. · Do not let alcohol confuse the clinical picture. Alcoholics frequently develop hypoglycemia · Low glucose (,60), normal glucose (60 – 120), high glucose (>250). · Consider Restraints if necessary for patient’s and/or personnel’s protection per the restraint procedure. Meds: Dextrose - D50% 25-50 g IV Glucagon- 1 mg IM Naloxone- 0.4-2 mg IV /IM (Start with lower dose) M Contact Medical Control M General Illness Fever / Nausea / Vomiting / Unknown History: · Age · Duration · Past medical history · Last Oral Intake · Medications · Immunocompromised · Blood emesis/diarrhea · Menstrual history · Environmental exposure Signs / Symptoms: ·Warm ·Sweaty · Flushed · Pain · Radiation · Abdominal distension · Chills/Rigors · Constipation · Diarrhea Differential: · Infections / Sepsis · Cancer / Tumors / Lymphomas · GI or Renal disorders · Heat Stroke · Medication or drug reaction · Vasculitis · Hyperthyroid · CNS disease/trauma · Myocardial infarction · Diabetic ketoacidosis · Gynecologic disease (ovarian cyst, PID) · Electrolyte abnormalities · Pregnancy · Psychologic Legend EMT A EMT-A A P EMT-P P M MC Order M Universal Patient Care Protocol Check Blood Glucose * Perform Cincinnati Stroke* Test A Obtain IV Access A A Fluid Bolus NS prn A P ECG / 12 lead prn P P Zofran or Diphenhydramine P Nausea/Vomiting? No P Acetaminophen P Consider Cooling measures No P Lorazepam P Consider
ems_protocols.3.21a.docx