Cgabryszek: Created page with "'''Any patient requiring ACLS care should have an ALS intercept if logistically possible''' {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Begin initial medical care # Administer oxygen # Assist ventilations if RR < 8 or > 35 # Assess for hypotension/ shock (HR >130, cap refill > 2 seconds) & follow shock protocol # '''Call for ALS intercept''' {| class="wikitable" |'''EMT- Emergency Medical Technician''' ''Perform/Confirm All Above Interventions..."

2022-04-03T21:47:34Z

Created page with "'''Any patient requiring ACLS care should have an ALS intercept if logistically possible''' {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Begin initial medical care # Administer oxygen # Assist ventilations if RR < 8 or > 35 # Assess for hypotension/ shock (HR >130, cap refill > 2 seconds) & follow shock protocol # '''Call for ALS intercept''' {| class="wikitable" |'''EMT- Emergency Medical Technician''' ''Perform/Confirm All Above Interventions..."

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'''Any patient requiring ACLS care should have an ALS intercept if logistically possible'''
{| class="wikitable"
|'''EMR - Emergency Medical Responder'''
|}

# Begin initial medical care
# Administer oxygen
# Assist ventilations if RR < 8 or > 35
# Assess for hypotension/ shock (HR >130, cap refill > 2 seconds) & follow shock protocol
# '''Call for ALS intercept'''

{| class="wikitable"
|'''EMT- Emergency Medical Technician''' ''Perform/Confirm All Above Interventions''
|}

# Assure ALS intercept is en route
# Transport as early as possible
# Reassess VS often during transport
# Apply ECG monitor & run strip (if trained, if time allows and after all other interventions are completed)
# Perform 12-lead ECG (if trained) as indicated

'''CONTACT MEDICAL CONTROL'''

{| class="wikitable"
|'''AEMT – Advanced Emergency Medicine Tech ''' ''Perform/Confirm All Above Interventions''
|}

# Start IV access en route, '''NS TKO''' (do not delay transport)
# Administer '''NS fluid bolus''', as directed

'''CONTACT MEDICAL CONTROL'''
{| class="wikitable"
|'''Intermediate ''' ''Perform/Confirm All Above Interventions''
|}

# Attach cardiac monitor if not already done, confirm rhythm via 12 lead ECG
# Observation and transport for '''asymptomatic''' tachycardia
# '''Narrow Complex Tachycardia (SVT)''' HR > 150
## Perform '''vagal maneuvers'''
## Give '''adenosine (Adenocard)''' rapid IV push followed by rapid saline flush, as near to IV site as possible
### Give '''6 mg''' & assess underlying rhythm; Transport without more adenosine if underlying rhythm is junctional, ectopic or multifocal atrial tachycardia
### Give '''12 mg''' if refractory SVT; May repeat '''12 mg''' if still refractory SVT
### Expedite transport if '''adenosine (Adenocard)''' is unsuccessful
## Reassess VS and rhythm frequently
## '''CONTACT MEDICAL CONTROL if:'''
### Known history of Wolff-Parkinson-White syndrome
### HR < 150
### '''Adenosine (Adenocard)''' was unsuccessful
# For '''Wide Complex''' '''Tachycardia''' (QRS > 0.12 sec)
## Assess for patient stability.
## If the patient is '''''UNSTABLE''''' (has a systolic BP less than 90, altered mental status, signs of shock, chest pain or acute heart failure):
### '''''Perform synchronized cardioversion'''''.
## If the patient is '''''STABLE''''':
### '''CONTACT MEDICAL CONTROL'''
### Administer '''amiodarone (Cordarone)''' 150 mg slow IV/IO over 10 min; May repeat (evaluate rhythm very closely, amiodarone may be contraindicated for torsades de point) -OR-
### Administer '''lidocaine''' 0.5 mg/kg IV/IO over 2 minutes, may repeat in 5-10 minutes

{| class="wikitable"
|'''Paramedic ''' ''Perform/Confirm All Above Interventions''
|}

'''CONTACT MEDICAL CONTROL'''

# For Torsades de Pointe, administer '''magnesium sulfate''' 1 gram over 60 minutes

2-5 STABLE TACHYCARDIA - Revision history