Prehospital Care Manual online - Contra Costa Health Services

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G11–GENERAL POISONING - OVERDOSE • If possible, determine substance, amount ingested, time of ingestion. Bring in container or label. • Be careful not to contaminate yourself and others DECONTAMINATION OXYGEN CARDIAC MONITOR Remove contaminated clothing, brush off powders, wash off liquids Irrigate eyes if affected BLS: Low flow unless ALOC / respiratory distress / shock ALS: Titrate to sPO of at least 94%. Be prepared to support ventilation. 2 CONSIDER IV TKO if unstable patient or suspected serious ingestion Related guidelines: Respiratory Depression or Apnea (G12), Altered Level of Consciousness (G2), Seizures (G14), Shock/Hypovolemia (A10, P8) TRICYCLIC ANTIDEPRESSANT OVERDOSE Frequently associated with respiratory depression, usually tachycardia. Widened QRS complexes and associated ventricular arrhythmias are generally signs of a life-threatening ingestion. For adults only: For life-threatening hemodynamically significant SODIUM BICARBONATE dysrhythmias, 1 mEq/kg slow IV or IO
ORGANOPHOSPHATE POISONING Hypersalivation, sweating, bronchospasm, abdominal cramping, diarrhea, muscle weakness, small/ pinpoint pupils, muscle twitching, and/or seizures may occur ATROPINE CALCIUM CHLORIDE CONSIDER MORPHINE SULFATE IV CONSIDER MORPHINE SULFATE IM For adults only: 1-2 mg IV • Repeat every 3-5 minutes as necessary until relief of symptoms • Large doses of Atropine may be required HYDROFLUORIC ACID EXPOSURE For adults only: For tetany or cardiac arrest, 500mg IV (5 ml of 10% solution) For adults only: In the absence of hypotension, significant other trauma or altered level of consciousness: 2-20 mg IV titrated in 2-5 mg increments to pain relief For adults only: If no IV access, 5-10 mg IM Key Treatment Considerations • Few overdoses have specific antidotes. Supportive care is the mainstay of treatment. Contact Base Hospital if any questions concerning treatment of overdose in pediatric patients • Contact Base Hospital for other suspected overdoses that may have specific treatment (e.g. Calcium Channel Blocker overdose) • Poison Control Center can offer information but cannot provide medical direction to EMS
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 22 and 23: A10-ADULT SHOCK / HYPOVOLEMIA HYPOV
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: • Closed head injury • Altered
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
Page 74 and 75: P3-PEDIATRIC NEONATAL CARE AND RESU
Page 76 and 77: P4-PEDIATRIC VENTRICULAR FIBRILLATI
Page 78 and 79: P5-PEDIATRIC PULSELESS ELECTRICAL A
Page 80: P6-PEDIATRIC SYMPTOMATIC BRADYCARDI
Page 83 and 84: UNSTABLE SUPRAVENTRICULAR TACHYCARD
Page 85: Key Treatment Considerations Succes
Page 89 and 90: IFT 1-TRANSFER INTERFACILITY TRANSF
Page 91: IFT 3-TRANSFER INTERFACILITY TRANSF
Page 96 and 97: DESTINATION DETERMINATION - BASIC P
Page 98 and 99: 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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