Allergic Reaction – Severe

Maintain airway Oxygen Epinephrine (1:1000) 0.3 mg (0.3 ml) SQ or IM Consider Albuterol 2.5 mg in 3 ml of 0.9% NaCl every 5 minutes x4 doses Diphenhydramine (Benedryl) 25-50 mg IV/IM Prednisone 60 mg PO Methylprednisolone 125 mg IV Consider Epinephrine (1:10,000) 0.1 mg increments slow IV (1.0 ml diluted in 9 ml 0.9%NaCl) […]

Anaphylactic Reaction – Moderate

Maintain airway Oxygen Consider albuterol 2.5 mg in 3 ml 0.9% NaCl via nebulizer every 5 minutes x4 doses Diphenhydramine (Benedryl) 25-50 mg IV/IM Epinephrine (1:1,000) 0.3 mg SQ. Contact medical control if there is a history or risk factors for coronary artery disease

Stroke

Obtain glucose reading via glucometer Assess patient for Stroke symptoms, using the Cincinnati Pre-hospital Stroke Scale for facial droop, pronator drift, and speech Determine as accurately as possible the time of symptom onset Transport to the closest appropriate hospital

Hypothermia

Handle carefully and prevent further heat loss If patient is alert enough to swallow, give food and drinks high in calories Oxygen, heated and humidified if possible IV fluids to maintain SBP >90 or minimum for age and signs of adequate perfusion For patients with altered level of consciousness, consider Narcan or D50W when appropriate […]

Hypoglycemia

Glucose level < 80 mg/dL or glucometer reads LOW If patient can swallow, 15g oral glucose or high glucose fluid (juice) If patient cannot swallow, 25g D50W via IV/IO If unable to establish IV/IO, 1mg Glucagon IM In the presence of chronic alcoholism, alcohol intoxication, or malnourishment, thiamine 100 mg IV/IM

Hyperglycemia

Obtain glucose level Consider ALS Intercept for abnormal vital signs or altered level of consciousness 0.9% NaCl via IV to maintain SBP >90 mmHg Airway management as needed

Head Trauma

Monitor and maintain SpO2 >90% If breathing is adequate, high flow O2 by NRB mask Do not hyperventilate, EXCEPT for a) Fixed or asymmetric pupils; b) abnormal extension; c) GCS

Altered Mental Status

Immobilize if evidence of trauma High flow oxygen via mask Determine blood glucose level; if < 80 mg/dl, administer D50W 25 g IV or if no IV glucagon 1 mg IM or SQ If object not visible, intubate the airway; push object down to obstruct right lung and allow air to left lung Administer naloxone […]