Seizure

M410 Assess for spinal injuries and treat/immobilize appropriately If actively seizing give Versed 10mg IM Versed 2-4mg/min IV/IM/IO, until seizure resolves or a total of 10mg is given Dextrose 50% 12.5 – 25g IV/IO or Glucagon 1 mg IM if Glucose < 70 Narcan 0.4 to 2mg IV if suspect narcotic OD If in the […]

Geriatric Trauma

SB213 GCS ≤ 14 Pulse > 90, SBP < 110 Fall from any height with evidence of traumatic brain injury, even from standing Pedestrian struck by motor vehicle Suspected long bone fx from motor vehicle crash Injuries sustained in two or more body regions Anticoagulation and head injury

Eye Injuries

S504 Stabilize impaled objects in place and cover other eye Cover penetrating eye injuries with metal eye patch—do not press on globe Irrigate chemicals or non-penetrating foreign matter from eye with copious amounts of water or normal saline Instill 2 drops of 0.5% proparacaine (Alcaine) or tetracaine into affected eye for pain (note it may […]

Burns – Major

S502 Scene safety; remove patient from source of burn, including clothing Maintain airway and administer oxygen If respiratory distress or unconscious, intubate immediately Cover burns with clean, dry sheet(s) or loose, dry sterile dressing Remove all prostheses, rings, and constricting bands from all extremities Consider pain management, per pain management protocol If hypovolemic, initiate fluid […]

Backboard / Spinal Immob

T704 Age >16, <65 Mechanism of injury concerning for spinal injury Immobilization is indicated only if any of the following are present: Altered mental status Suspicion of intoxication Distractions – either painful injuries or psychosocial distractions Midline spinal tenderness (careful palpation exam required) Focal neurological deficit (anything less than a full & symmetric motor and […]

Pediatric Toxicological Emergency

P611 If narcotic overdose, naloxone 0.1 mg/kg IV/IM/IN/IO (max 2 mg) If toxin remains on patient, wash or brush off as appropriate. Alert medical control if patient will require further decontamination; patient NOT to be brought through regular Triage. For eye exposure, flush the eyes with 0.9% NaCl for at least 15 min If patient […]

Pediatric Pain Management

P612 For children 5-15 y.o with extremity injury or burn Administer a single dose of either: Fentanyl 1 mcg/kg IV/IO (max 50 mcg for pain) – administer over 3-5 minutes slow IV push to prevent rigid chest Fentanyl 2 mcg/kg intranasal (max 100 mcg for pain) – use the undiluted injectable fentanyl product (100 mcg/2 […]

Pediatric Diabetic Reaction

P608 IF blood glucose is < 70 mg/dl: If dysrhythmia present, proceed to appropriate protocol For shock, push 20 ml/kg 0.9%NaCl IV/IO (max 1 L) If glucose ≤70, administer 1 ml/kg D50W IV/IO push; If child ≤3 y.o. or ≤ 15 kg, instead push 2 ml/kg of D25 IV/IO (D25 is made by mixing D50 […]