Paramedic Kardex

The is a quick reference ONLY to the Policies and Guidelines set by OCEMSA.
All specific Treatment Guidelines questions should be directed to the OCEMSA Website.
ADULT
Asystole or PEA
Algorithm
Initiate or maintain CPR
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►IV/IO vascular access without interruption of CPR
For PEA administer Fluid Bolus before other treatments
►250 mL NS bolus, may repeat to max of 1 liter to attain and maintain perfusion
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►Epinephrine 1 mg IV / IO (0.1 mg/mL) approximately every 3 minutes
→ Correct possible reversible causes:
Hypovolemia, acidosis, hypoxia, tension pneumothorax, hypothermia, toxins
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►D10 25 gm/250 mL (50% solution) IVPB / IO
If diabetic and hypoglycemia suspected: (No D-stick, Non-Traumatic FA)
Epinephrine can be given with D10, there is no negative reaction
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Advanced Airway with minimal interruption of CPR after 4-6 min of CPR
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If prior to transport the pt develops a rhythm with pulse:
Make BHC and transport to available Cardiovascular Receiving Center (CVRC)
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For continued PEA or asystole:
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→ Maintain CPR and transport to nearest PRC or make Base contact to: Provide further resuscitation orders
Request pronouncement of patient in the field
→Interruption of chest compressions should always be held to a minimum
→Agonal gasps are not adequate breathing and when accompanied with a pulseless state, the patient should be considered to be in full cardiopulmonary arrest
→If Base Hospital orders Push-Dose Epinephrine for refractory hypotension, refer to Push-Dose Epinephrine procedure
1:10,000 = 0.1mg/mL
1:1000 = 1mg/mL