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Fall 2019 Updates

Pit Crew CPR

  • New high performance CPR policy

 

Hyperglycemia

  • Glucose <250 and Asymptomatic = BLS Transport

  • Glucose 250-400 and Asymptomatic = BLS Transport

  • Glucose 250-400 and Symptomatic = ALS Transport + Fluids

  • Glucose 400+ = ALS Transport + Fluids (if Symptomatic)

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Left Ventricular Assist Device (LVAD)

  • Only change is the addition of contacting a CCERC for Base Contact

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Cardiopulmonary Arrest - PEDS

  • Only change is the addition of contacting a CCERC for Base Contact

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Allergic Reaction / Anaphylaxis - PEDS

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Burn (Thermal, Electrical, Chemical) - PEDS

  • Only change is the addition of contacting a CCERC for Base Contact

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9-1-1 Advanced Life Support Base Contact, Standing Order, and Transport Criteria

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Ambulance Transport Ventilator

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Spring 2019 Updates

GLASGOW​

  • The GlasgowComa Scale should be reported to the MICN explaining each element. “Patient is a 4, 5, 6 for a total of 15.”

 

PVAD

  • PVADs can only be accessed as a Standing Order on full arrests, all other times is a Base Order.

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CYANIDE POISONING

  • Addition of Hydroxocobalamin as a drug and CynoKit as a procedure.  This is for smoke inhalation calls.  The BCs will have the Drug in the near future.

 

SUPRAGLOTTIC AIRWAYS

  • New Supraglottic Airways are approved for Orange County, and now can be used as the primary airway; King or iGel.

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ALLERGIC REACTIONS:

  • Rash only = Transport

  • Facial/Cervical Angioedema = Epi 0.5 mg IM, lateral thigh, Benadryl 50 mg

  • Wheezing or Hypoxia = Epi 0.5 mg IM, lateral thigh, Benadryl 50 mg, Albuterol, may repeat the Epi twice for a total of 3.

  • Anaphylaxis = Epi 0.5 mg IM, lateral thigh, Benadryl 50 mg, repeat Epi IM or IV in 5 min., Base contact after that.

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STROKE TRIAGE:

  • Deleted seizure, hypoglycemia, and GCS from exclusion criteria.  Changed the time frame from 7 hours to 24 hours.

 

I-20 CHART

  • Corrected some drug dosing on the I-20 chart

 

TRAUMA CRITERIA:​

  • Deleted GCS from criteria

  • Added Failure to follow commands

  • Deleted flail chest

  • Added blunt chest injury with abdominal respirations

  • Added any abdominal tenderness

  • Added pregnant with blunt or penetrating trauma

  • Added blunt head injury with bruising and anticoagulation

  • Added EMS judgment 

  • Deleted special considerations

 

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DNR:

  • Added language to address death at scene

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