Cgabryszek: Created page with "'''General Considerations''' * Take body substance isolation precautions en route to the scene. * Initiate immediate ALS backup as appropriate * Preparation for transport of patient should begin immediately as staffing allows. * The patient should be transported when one of the following has occurred: * The patient regains a pulse * Two (2) shocks have been delivered by EMS staff * Per medical control recommendation * All contact with the patient must be avoided during..."

2022-04-04T02:42:22Z

Created page with "'''General Considerations''' * Take body substance isolation precautions en route to the scene. * Initiate immediate ALS backup as appropriate * Preparation for transport of patient should begin immediately as staffing allows. * The patient should be transported when one of the following has occurred: * The patient regains a pulse * Two (2) shocks have been delivered by EMS staff * Per medical control recommendation * All contact with the patient must be avoided during..."

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'''General Considerations'''

* Take body substance isolation precautions en route to the scene.
* Initiate immediate ALS backup as appropriate
* Preparation for transport of patient should begin immediately as staffing allows.
* The patient should be transported when one of the following has occurred:
* The patient regains a pulse
* Two (2) shocks have been delivered by EMS staff
* Per medical control recommendation
* All contact with the patient must be avoided during analysis of rhythm and delivery of shock(s)
* Do not apply AED in children under 1 year of age. If patient is under one year of age, begin CPR and transport. Contact medical control for further instructions.
* A pediatric capable AED is preferred for age 1-8 years. However, a standard AED may be used if it is the only one available.

'''AED Application by Age'''

* Age 1 through 8 years
** Perform CPR for 5 cycles (about 2 minutes) before undertaking other actions
** Apply AED, using a pediatric capable AED if available
** If only standard AED available, it may be applied. It is recommended to place the patches in anterior-posterior positions to avoid arcing.
* Age > 8 years
** Apply standard AED

'''Resuscitation (EMS Provider)'''

# Arrive on scene and perform initial assessment
# Stop CPR if in progress
# Verify pulselessness and apnea
# If no CPR (or poor quality CPR) performed prior to your arrival and response interval from time of collapse is:
## Less than 5 minutes, the immediate priority is defibrillation
## More than 5 minutes, perform two (2) minutes of CPR prior to defibrillation.
# If three or more shocks have been given by PAD and patient remains pulseless, consider one additional shock if indicated and begin immediate transport.
# AED Activation and Use
## Attach and activate defibrillator
## Stop CPR
## Clear patient
## Initiate analysis of rhythm
## If AED advises shock:
### Deliver shock
### Immediately begin CPR and prepare for immediate transport
## After 2 minutes, stop CPR assess ABC’s
## If no return of carotid pulse, allow AED to re-analyze
## If shock advised, deliver shock and perform two minutes of CPR
## The sequence of two (2) minutes of CPR followed by one shock may be repeated a maximum of three times.
## After two shocks no delay should be made remaining on the scene. This may require the third shock being performed in the ambulance.
## If after the shock, patient exhibits signs of life (spontaneous respirations, purposeful motor activity) stop CPR and assess ABC’s.
## If breathing adequately, Administer high concentration oxygen by non re-breather mask and transport promptly
## If not breathing adequately, artificially ventilate with high concentration oxygen, transport promptly (consider insertion of advanced airway here).
## If AED advises no shock:
### Resume CPR and begin immediate transport
## After two minutes of CPR allow re-analysis
### If shock advised, deliver shock.
### If no shock advised for the second time, resume CPR and begin immediate transport.
## Consider insertion of an advanced airway when appropriate
### Airway should be inserted while chest compressions continue
## Once airway is in place, ventilations should be made at the rate of 8-10 per minute and CPR should be performed for two minutes between re-analyzing or pulse check.
## If at any time during transport pulses are lost, restart protocol.
# Medical Control should be contacted as soon as possible to discuss further treatment option including termination of resuscitation.
# If ambulance not at scene continue the sequence of two minutes CPR followed by analysis for as long as shockable rhythm persists or until transport becomes possible.

'''Document'''

* Clinical assessment
* Whether arrest was witnessed or un-witnessed
* Presence of by-stander CPR
* Defibrillator use including PAD
* Resuscitative measures and response
* Communication with medical control

5-1 SEMI-AUTOMATED EXTERNAL DEFIBRILLATOR USE - Revision history