About
Section 1: General Patient Care
Section 2: Medical Protocols
2.01 - Adrenal Insufficiency / Crisis (Adult & Pediatric)2.02A - Allergic Reaction / Anaphylaxis2.02P - Allergic Reaction / Anaphylaxis2.03A - Altered Mental / Neurological Status / Diabetic Emergencies / Coma - Adult2.03P - Altered Mental / Neurological Status / Diabetic Emergencies / Coma - Pediatric2.04 - Behaviorial Emergencies (Adult & Pediatric)2.05 - Behaviorial Emergencies - Restraints (Adult & Pediatric)2.06A - Bronchospasm / Respiratory Distress (Adult)2.06P - Bronchospasm / Respiratory Distress (Pediatric)2.07 - Hyperthermia (Environmental - Adult & Pediatric)2.08 - Hypothermia (Environmental - Adult & Pediatric)2.09 - Nerve Agent / Organophosphate Poisoning2.10 - Obstetrical Emergencies2.11 - Newly Born Care2.12 - Resuscitation of the Newly born2.13 - Pain and Nausea Management2.14 - Poisoning / Substance Abuse / Overdose2.15A - Seizures2.15P - Seizures2.16A - Shock2.16P - Shock2.17A - Sepsis2.17P - Sepsis2.18 - Stroke2.19 - Hyperkalemia2.20 - Home Hemodialysis Emergency Disconnect
Section 3: Cardiac Emergencies
Section 4: Trauma Protocols
Section 5: Airway Protocols & Procedures
Section 6: Medical Director Options
Section 7: Medical Policies & Procedures
Section 8: Special Operations Principles
Appendices
2.02A - Allergic Reaction / Anaphylaxis
First-Responder (Standing Orders)
- Monitor for severe distress.
- Epinephrine auto-injector 0.3mg or IM in accordance withProtocol 6.6 Check and Inject Epinephrine for BLS Providers.
- 2nd dose may be administered in 5 minutes if necessary.
First-Responder (Medical Control)
- If patient is greater than 65 years old, First Responders and EMTs must contact Medical Control to administer a second dose.
EMT-Basic (Standing Orders)
EMT-Advanced (Standing Orders)
- Albuterol 2.5mg via nebulizer. Repeat every 5 minutes up to 4 doses.
- If approved, epinephrine 1:1,000 0.3mg IM-ONLY. Must be administered in accordance with criteria listed inA1 Adult Medication Reference.
EMT-Paramedic (Standing Orders)
- Hydrocortisone 100 mg IV/IO/IM, or methylprednisolone 125 mg IV/IO/IM.
- Mild Distress:
- Diphenhydramine 25-50 mg IV/IO/IM.
EMT-Paramedic (Medical Control)
- Additional doses of above medications.
- Epinephrine 1:10,000 Bolus: 0.1 mg – 0.5 mg IV/IO.
- Epinephrine 1:10,000 Infusion: 2-10 mcg/min IV/IO.
- Norepinephrine infusion by pump: 0.1-0.5 mcg/kg/min IV/IO, titrate to goal systolic blood pressure of 90mmHg.
- Dopamine infusion: 2-20 mcg/kg/min IV/IO
Caution:
Epinephrine for anaphylaxis must be administered by Auto-Injector or IM if trained and authorized to do so in accordance withMedical Director Option Protocol 6.6 Check and Inject Epinephrine for BLS Providers
Note:
- Mild Distress : itching, urticaria, nausea, and no respiratory distress.
- Severe Distress : stridor, bronchospasm, severe abdominal pain, respiratory distress, tachycardia, shock, edema of lips, tongue or face.