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
2.10 - Obstetrical Emergencies
EMT-Basic (Standing Orders)
EMT-Advanced (Standing Orders)
- 1.0 Routine Patient Care
- Expose as necessary to access for bleeding/discharge, crowning, prolapsed cord, breech, limb presentation.
- Do not digitally examine or insert anything into the vagina.
- Exceptions: fingers may be inserted to manage baby’s airway in breech presentation or to treat prolapsed or nuchal cord.
- Place mother in left-lateral recumbent position except as noted:
- Prolapsed cord:
- Knee-chest position or Trendelenburg position
- If only the cord has prolapsed and the presenting part has yet to go through the cervix, gently elevate the presenting part to remove pressure on the umbilical vessels to permit blood flow through cord.
EMT-Paramedic (Standing Orders)
- Eclamptic Seizures
- Midazolam 2 - 6 mg slow IV/IO/IM or
- Midazolam 2 - 6 mg IN
- Magnesium sulfate 2-4 grams IV/IO over 5 minutes.
EMT-Paramedic (Medical Control)
- Administration of additional IV Normal Saline.
- Calcium chloride 10% 20 mg/kg IV/IO administer slowly over 5 minutes to a maximum dose of 1 gram. (Antidote for Magnesium Sulfate).
- Further anticonvulsant therapy.
Note:
Special Considerations in Cardiac Arrest (with additional resources)
- If the fundus height is at or above the level of the umbilicus