Prehospital Care Manual online - Contra Costa Health Services

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A10–ADULT SHOCK / HYPOVOLEMIA HYPOVOLEMIC OR SEPTIC SHOCK - Signs and symptoms of shock with dry lungs, flat neck veins May have poor skin turgor, history of GI bleeding, vomiting or diarrhea, altered level of consciousness May be warm and flushed, febrile, may have respiratory distress Sepsis patients may or may not have an associated fever CARDIOGENIC SHOCK Signs/symptoms of shock, history of CHF, chest pain, rales, shortness of breath, pedal edema HYPOVOLEMIA WITHOUT SHOCK No signs of shock, but history of poor fluid intake or fluid loss (e.g. vomiting, diarrhea). May have tachycardia, poor skin turgor. OXYGEN BLS/ALS: High flow. Be prepared to support ventilations as needed. CONSIDER CPAP If suspected pulmonary edema / cardiogenic shock ADDRESS Keep patient warm if suspected hypothermia HYPOTHERMIA CARDIAC MONITOR Treat dysrhythmias per specific treatment guideline EARLY TRANSPORT CODE 3 IV OR IO TKO only if suspected pulmonary edema • For hypovolemic or septic shock, 500 ml NS bolus. May repeat once. FLUID BOLUS • For hypovolemia (poor intake/fluid loss), 250 ml NS bolus. May repeat X 1. Do not administer bolus if pulmonary edema or cardiogenic shock suspected
CONSIDER 12-LEAD ECG If cardiac etiology for shock suspected Check temperature, use sepsis screening tool and advise hospital of positive sepsis screen if indicated A positive sepsis screen in adults occurs in the setting of suspected SEPSIS SCREEN infection when 2 of 3 conditions are met: • Heart rate/pulse greater than 100; • Respiratory rate greater than 20; • Temperature above 100.4 or below 96 BLOOD GLUCOSE Check and treat if indicated Related guidelines: Altered level of consciousness (G2), Respiratory Depression or apnea (G12)
Page 1 and 2: contra costa county emergency medic
Page 3: A1 — Adult Patient Care A2 — Ch
Page 6 and 7: A2-ADULT CHEST PAIN SUSPECTED ACUTE
Page 8 and 9: A3-ADULT CARDIAC ARREST - INITIAL C
Page 10 and 11: A4-ADULT VENTRICULAR FIBRILLATION P
Page 12 and 13: A5-ADULT PULSELESS ELECTRICAL ACTIV
Page 14 and 15: A6-ADULT SYMPTOMATIC BRADYCARDIA He
Page 16 and 17: A7-ADULT VENTRICULAR TACHYCARDIA WI
Page 18 and 19: A8-ADULT SUPRAVENTRICULAR TACHYCARD
Page 20 and 21: A9-ADULT OTHER CARDIAC DYSRHYTHMIAS
Page 24 and 25: A11-ADULT POST-CARDIAC ARREST CARE
Page 26 and 27: A12-ADULT PUBLIC SAFETY DEFIBRILLAT
Page 29: G1 — Allergy and all patients G9
Page 33 and 34: If serious progression of symptoms
Page 35 and 36: Key Treatment Considerations • Na
Page 37 and 38: CONSIDER CHEMICAL RESTRAINT MONITOR
Page 39 and 40: Key Treatment Considerations • Ai
Page 41 and 42: COMPLICATED DELIVERY BREECH DELIVER
Page 43 and 44: G7-GENERAL ENVENOMATIONS (Bites/Sti
Page 45 and 46: Key Treatment Considerations • Se
Page 47 and 48: Key Treatment Considerations • Av
Page 49 and 50: • Closed head injury • Altered
Page 51 and 52: ORGANOPHOSPHATE POISONING Hypersali
Page 53 and 54: Key Treatment Considerations SAFETY
Page 55 and 56: NITROGLYCERIN CONSIDER MORPHINE SUL
Page 57 and 58: Key Treatment Considerations • Mo
Page 59 and 60: CINCINNATI STROKE SCALE If any one
Page 61 and 62: INDICATIONS AND PRECAUTIONS FOR MOR
Page 63 and 64: G16-GENERAL TRAUMA - EXTREMITY cons
Page 65: CONSIDER ONDANSETRON For severe nau
Page 70 and 71: P1-PEDIATRIC PEDIATRIC PATIENT CARE
Page 72 and 73:
P2-PEDIATRIC CARDIAC ARREST - INITI
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P3-PEDIATRIC NEONATAL CARE AND RESU
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P4-PEDIATRIC VENTRICULAR FIBRILLATI
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P5-PEDIATRIC PULSELESS ELECTRICAL A
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P6-PEDIATRIC SYMPTOMATIC BRADYCARDI
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UNSTABLE SUPRAVENTRICULAR TACHYCARD
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Key Treatment Considerations Succes
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IFT 1-TRANSFER INTERFACILITY TRANSF
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IFT 3-TRANSFER INTERFACILITY TRANSF
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DESTINATION DETERMINATION - BASIC P
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GENERAL DESTINATION PRINCIPLES PATI
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BASE HOSPITAL DESTINATION DECISION
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OBVIOUS DEATH MEDICAL ARREST TRAUMA
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ABUSE REPORTING RESPONSIBILITIES EM
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RESTRAINT TYPES RESTRAINT ISSUES LA
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BACKGROUND SITE REQUIREMENTS PROCED
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HAZMAT RECOGNITION WHILE ON SCENE (
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ON-VIEWS • In the event that a no
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12-LEAD ACQUISITION AND LEAD PLACEM
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STEMI RECOGNITION STEMI REPORT DEST
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TRANSMISSION OF MONITOR DATA • 12
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AIRWAY POSITIONING Position the pat
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KEY PROCEDURES Skill Indication / C
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Oxygen Safety Initial Indications f
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PAIN ASSESSMENT AND MANAGEMENT Reli
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PEDIATRIC ASSESSMENT Begin interven
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PEDIATRIC MEDICATION ADMINISTRATION
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SEPSIS SCREENING • Sepsis is a li
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VASCULAR ACCESS Skill Indication /
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TREATMENT DESTINATION AND DISPOSITI
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TIER ZERO TIER ONE TIER TWO TIER TH
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SBAR REPORTING SBAR is a tool that
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EMT SCOPE OF PRACTICE (STATE REGULA
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PARAMEDIC SCOPE OF PRACTICE Califor
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PARAMEDIC SCOPE OF PRACTICE (contin
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Kaiser Medical Center - Antioch 500
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OUT-OF-COUNTY SPECIALTY CENTERS Hos
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ADULT DRUG REFERENCE Drug Indicatio
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ADULT DRUG REFERENCE Drug Indicatio
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NALOXONE ADULT DRUG REFERENCE Drug
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PEDIATRIC DRUG REFERENCE Drug Indic
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Yellow (12-14 kg) 2.7 mg 2nd - 0.9
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Assure adequate ventilation before
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Note: Cardioversion energy dosages
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Consider giving one-half dosage dip
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45 kg 0.3 mg 0.3 ml IM / SC 40 kg 0
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45 kg 1 mg 1 ml Green (30-36 kg) 1
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40 kg 4 mg 0.8 ml 45 kg 4.5 mg 0.9
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For patients 19 kg and above may ti
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45 kg 45 kg 101 lbs Green 30-36 kg
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0 0 1-2 MILD 1-2 LEVE PAIN RATING S
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