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
2.17A - Sepsis
Note:
- IDENTIFICATION OF POSSIBLE SEPTIC SHOCK
- Suspected infection – YES
- Evidence of sepsis criteria-YES (2 or more):
- Temperature less than 96.8 ° F or greater than 100.4 ° F
- Heart Rate greater than 90 bpm
- Respiratory rate greater than 22 bpm
- Systolic BP less than 90 mmHg OR Mean Arterial Blood Pressure (MAP) less than 65 mm Hg
- New onset altered mental status OR increasing mental status change with previously altered mental statu
- Serum Lactate level greater than 4 mmol/l-(if trained and equipment available)
- ETCO2 less than or equal to 25 mmHg
EMT-Basic (Standing Orders)
- 1.0 Routine Patient Care
- Notify hospital of incoming Sepsis Alert prior to arrival if applicable
- Supplemental oxygen to achieve SpO2 of 94%
EMT-Advanced (Standing Orders)
- Full ALS Assessment and treatment
- Large bore IV access
- IV 0.9% NaCl enroute: administer 500 ml boluses up to 30cc/kg
- Warning: assess lung sounds frequently to ensure volume overload does not occur
EMT-Paramedic (Medical Control)
- Norepinephrine infusion by pump 0.1-0.5 mcg/kg/min IV/IO by pump, titrate to goal systolic Blood Pressure of 90mmHg, OR
- Epinephrine infusion 2-10 mcg/min IV/IO OR
- Dopamine 2-20 mcg/kg/min IV/IO.
- Additional Fluid boluses.
Caution:
This protocol is for adult patients 18 years old or older