Protocol Update 1/5/05
New Medication
| Medication | Prehospital Indications | Contraindications | Side Effects | Dosage | Protocol |
| Phenergan | Nausea and Vomiting | Comatose States | Drowsiness, CNS Depression | 12.5mg IV, 25mg IM | Nausea and Vomiting Effective 2/1/05 |
Protocol Updates -
February 1, 2005
Nausea and Vomiting Protocol
New Issue of medication - Phenergan (12.5mg IV)
Anaphylaxis Protocol
Add Solu-Medrol 125mg IV or IM after Benadryl dosage.
Asystole
No Change
Bradycardia
Medical Command will consider use of Dopamine if Atropine is not effective.
Behavioral Emergencies - NEW PROTOCOL
- To be used only after physical restraint is unsuccessful
- Patient must be over 45kg
- Versed 1-2mg IV q 2 minutes up to 7mg
C-Spine Clearance - NEW PROTOCOL
- Follow established Algorithm in Protocol Book
Chest Pain
- Morphine 2-5mg provided there are no contraindications. Given after ASA. Morphine
may now be repeated one time after 5 minutes if pain persists.
Hypothermic Arrest
- Consider facility w/Emergency Cardio-Pulmonary Bypass capabilities
- IV NSS 500cc Bolus instead of KVO
- Epinephrine 1mg IV or 2mg ET
Labor and Delivery Protocol
- No Change
Medical High Risk Protocol - NEW PROTOCOL
- Indicated for: Severe Abdominal Pain, Stroke, Syncope, GI Hemorrhage,
Marked Dehydration, Overdoes, Environmental Emergencies, Ruptured
Abdominal Aortic Aneurysm
- IV NSS (large bore) Second line of NSS enroute.
- Consider Dopamine if BP<90 systolic.
Pain Protocol - NEW PROTOCOL
- Indicated for: Suspected Fractures, Dislocations, Severe Sprains,
Lacerations, Abrasions (road rash), Any condition warranted by
Command Physician.
- Morphine Sulfate 2-5mg IV, IM or SQ. May be repeated x1 in 5 minutes
if necessary and/or Nitrous Oxide provided patient can self-administer.
PEA
- No Change
Sedation for Painful Procedures - NEW PROTOCOL
- Read the considerations in the new protocol book thoroughly
- Morphine 2-5mg IV if not contraindicated
- Versed 1-2mg IV q 2 minutes to a max. dose of 6mg provided BP >100mm
Shortness of Breath Protocol
- For COPD patients add Solu-Medrol administration after 1:1000
Epinephrine SQ
- Considerations REMOVE Terbutaline consider only Magnesium Sulfate
Stroke Protocol - NEW PROTOCOL
- Review Criteria in handbook
- 50% Dextrose (if no IV access consider Glucagon 1mg IM)
- < 6 hours since onset transport to Stroke Center
Tachycardia Protocol
- Second dose of Adenosine 12mg IV followed by 10ml NSS bolus now
added and can be repeated if necessary
- Consider Cardizem after contacting Medical Command
Trauma Protocol - NEW PROTOCOL
- Start 2 Large Bore IVs of NSS
- NSS 500 ml Bolus and re-assess if BP<90mm HG
V. Fib/V. Tachy Protocol
- Increase dosage of Lidocaine after Amiodorone from
1mg to 1.5mg/kg.
q 3-5 minutes (total 3mg/kg)