User contributions for Cgabryszek
From CRS EMS Guidelines
- 16:27, 3 April 2022 diff hist +1,926 N 2-15 PSYCHIATRIC & BEHAVIORAL EMERGENCIES Created page with "Also consider medical causes of altered mental status, especially hypoglycemia. Enlist Law Enforcement as needed to assist with safe management of the scene and patient. {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # '''Scene safety''' is a priority # Additional resources as needed. Law Enforcement if patient resistant or violent. # Initial assessment # Patient interaction ## Be calm and reassuring ## Verbal de-escalation of agitation ## Enlist La..." current Tag: Visual edit
- 16:25, 3 April 2022 diff hist +2,780 N 2-14 ALTERED MENTAL STATUS Created page with "Considerations: cardio-respiratory arrest, airway obstruction, shock, stroke, seizure, trauma, overdose, diabetic complications, hypo/hyperthermia. Evaluate for suspected child abuse in infants with altered mental status or new seizures. {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Perform an initial assessment, confirm ABCs ## If apneic, pulseless or in shock/hypotension, refer to appropriate protocol. ## Cervical spine precautions are to be..." current Tag: Visual edit
- 16:22, 3 April 2022 diff hist +1,626 N 2-13 ABDOMINAL-BACK PAIN (SUSPECTED AAA) Created page with "Hypotension can be defined as systolic blood pressure less than 90mmHg in adults. Shock is indicated by symptoms of inadequate perfusion: pale, cool, and clammy skin, change in mental status, ischemic chest pain, etc. {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Evaluate ABC’s # Apply oxygen or support ventilations. Monitor airway and breathing closely. # Place the patient in Trendelenburg position as tolerated by airway control and respirator..." current Tag: Visual edit
- 16:21, 3 April 2022 diff hist +3,336 N 2-12 RESPIRATORY DISTRESS Created page with "Considerations: airway obstruction, foreign body aspiration, chemical exposure, asthma, chronic obstructive pulmonary disease, emphysema, pulmonary edema, upper respiratory infection, bronchitis, pneumonia, pneumothorax, pulmonary embolus, bronchospasm with anaphylaxis. Note: Anxiety and hyperventilation, while possible, are not prehospital diagnoses. Respiratory distress will be treated with oxygen appropriate for the symptoms and delivery device applied. '''Any patient..." current Tag: Visual edit
- 16:18, 3 April 2022 diff hist +6,947 N 2-11 ACUTE ALLERGIC REACTION Created page with "A condition in which the patient has been exposed to an allergen such as bee stings, certain foods or medicines and exhibits any or all of the following symptoms: itching, hives, respiratory distress, airway swelling, and hypotension {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Initial assessment. ## It is useful, but not necessary to identify source of reaction. ## Assess for latex allergy and utilize latex-free equipment as needed. ## Time fro..." current Tag: Visual edit
- 16:11, 3 April 2022 diff hist +3,686 N 2-10 ACUTE CVA (STROKE) Created page with "'''''Goal scene time is less than 10 minutes.''''' {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Perform an initial assessment, confirm ABCs ## Cervical spine precautions are to be taken if circumstances surrounding the event are not known or indicate a possible spine or head injury. # Begin initial medical care with emphasis on maintaining a functional airway ## Refer to the airway protocol ## Apply high-flow oxygen, if not already done ## If no..." current Tag: Visual edit
- 16:06, 3 April 2022 diff hist +8 2-9 ADULT CHEST PAIN current Tag: Visual edit
- 16:06, 3 April 2022 diff hist +4,144 N 2-9 ADULT CHEST PAIN Created page with "Life threatening etiologies for chest pain, such as acute MI, aortic dissection, pulmonary embolism and others, should be considered in all patients with a complaint of chest pain regardless of age. If the etiology is unclear, the provider should '''consult Medical Control''' and err on the side of cardiac treatment. {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Perform initial assessment to include: # Time of onset of symptoms or change in symptom..." Tag: Visual edit
- 15:58, 3 April 2022 diff hist +2,280 N 2-8 ACUTE ST ELEVATION MYOCARDIAL INFARCTION Created page with "Note: This protocol assumes that the patient has already had a 12 lead EKG diagnostic of an Acute ST Elevation MI. Patients with suspected MI should be treated via the Adult Chest Pain protocol until 12 Lead EKG done and evaluated. EKG findings diagnostic of ST Elevation MI are ST elevations of > 1mm in 2 or more contiguous leads or any patient with a Left Bundle Branch Block and symptoms consistent with cardiac chest pain. '''Time from onset of symptoms to reperfusion..." current Tag: Visual edit
- 15:56, 3 April 2022 diff hist +3,276 N 2-7 MEDICAL HYPOTENSION - SHOCK Created page with "Hypotension is defined as systolic BP less than 90mmHg in adults. Shock is a state of decreased tissue oxygenation. Significant vital organ hypoperfusion may be present without hypotension. Clinical signs and symptoms of hypoperfusion include pale, cool, and clammy skin, tachycardia, altered mental status; ischemic chest pain, etc. Home medications and/or comorbidities may limit development of tachycardia. Goal of therapy is to maximize oxygen delivery to tissues wit..." current Tag: Visual edit
- 15:52, 3 April 2022 diff hist +2,924 N 2-6 BRADYCARDIA (SYMPTOMATIC) Created page with "Symptomatic dysrhythmia may be indicated by: acute altered mental status, ongoing severe ischemic chest pain, congestive heart failure, hypotension, or other signs of shock that persist despite adequate airway and breathing. '''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..." current Tag: Visual edit
- 15:47, 3 April 2022 diff hist +2,817 N 2-5 STABLE TACHYCARDIA 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..." current Tag: Visual edit
- 15:42, 3 April 2022 diff hist +5,578 N 2-4 UNSTABLE TACHYCARDIA Created page with "Symptomatic dysrhythmia may be indicated by: acute altered mental status, ongoing severe ischemic chest pain, congestive heart failure, hypotension, or other signs of shock that persist despite adequate airway and breathing. '''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 >..." current Tag: Visual edit
- 15:35, 3 April 2022 diff hist +1,848 N 2-3 ADULT CARDIAC ARREST: CEREBRAL COOLING PROTOCOL Created page with "{| class="wikitable" |'''EMT - Emergency Medical Technician''' ''Perform/Confirm All Above Interventions'' |} This protocol is designed to be implemented by providers at the Intermediate and paramedic levels only due to the need for a functioning IV and advanced airway. It assumes the provider has followed all of the steps in the Adult CCR protocol prior to institution. '''Inclusion Criteria:''' # Patient sustained a witnessed cardiac arrest from V-tach, V-fib or PEA..." current Tag: Visual edit
- 15:00, 3 April 2022 diff hist +6,888 N 2-2 ADULT CARDIAC ARREST: CARDIO-CEREBRAL RESUSCITATION Created page with "{| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Establish that the patient is unresponsive, without a pulse, and not breathing. # Check for DNR bracelet, dependent lividity, rigor mortis, or other indications to withhold CPR. # Initiate Resuscitation: ## Follow American Heart Association Guidelines for use of the AED. # Perform Effective Chest Compressions: ## Push hard and fast, between 100 - 120 compressions per minute. ## Allow for complete chest r..." current Tag: Visual edit
- 14:52, 3 April 2022 diff hist +2,295 N 2-1 ASYSTOLE-PEA Created page with "'''Any patient requiring ACLS care should have an ALS intercept if logistically possible''' {| class="wikitable" |'''EMR - Emergency Medical Responder''' |} # Establish unresponsiveness and PNB status # Provide CPR as outlined in the Adult Cardiac Arrest: Cardio-Cerebral Resuscitation Protocol # '''Call for ALS intercept''' # Prepare for transport {| class="wikitable" |'''EMT- Emergency Medical Technician''' ''perform/confirm all above interventions'' |} '''Assure..." current Tag: Visual edit
- 14:41, 3 April 2022 diff hist 0 2 - Adult Medical current Tag: Visual edit
- 14:38, 3 April 2022 diff hist +24 1-19 STANDARD MINIMUM DRUG AND SOLUTION LIST current Tag: Visual edit: Switched
- 14:37, 3 April 2022 diff hist +27 1-19 STANDARD MINIMUM DRUG AND SOLUTION LIST
- 14:31, 3 April 2022 diff hist +1,817 N 1-19 STANDARD MINIMUM DRUG AND SOLUTION LIST Created page with "(Paramedic Units) Standard Drugs 5 adenosine (Adenocard) vials (6 mg) 2 albuterol (Ventolin) pre-mixed solution for nebulization (2.5 mg) (may also carry DuoNeb Solution) 3 amiodarone (Cordarone)(150/3mL) 12 ASA (81 mg) 2 atropine ampules (1 mg) (Optional based on operational needs, but must carry some formulation) 3 atropine sulfate pre-filled syringes (1 mg/10 mL) 1 calcium chloride 10% pre-filled syringe (1 gram/10 mL) 2 dextrose 50% pre-filled syringes (25 gra..." Tag: Visual edit: Switched
- 14:21, 3 April 2022 diff hist −2 1 - Policies current Tag: Visual edit
- 14:21, 3 April 2022 diff hist −4 1 - Policies Tag: Visual edit
- 14:19, 3 April 2022 diff hist +1,817 N 1-19 STANDARD MINIMUM DRUG AND SOLUTION STOCK LIST Created page with "(Paramedic Units) Standard Drugs 5 adenosine (Adenocard) vials (6 mg) 2 albuterol (Ventolin) pre-mixed solution for nebulization (2.5 mg) (may also carry DuoNeb Solution) 3 amiodarone (Cordarone)(150/3mL) 12 ASA (81 mg) 2 atropine ampules (1 mg) (Optional based on operational needs, but must carry some formulation) 3 atropine sulfate pre-filled syringes (1 mg/10 mL) 1 calcium chloride 10% pre-filled syringe (1 gram/10 mL) 2 dextrose 50% pre-filled syringes (25 gra..." current
- 14:14, 3 April 2022 diff hist −67 1 - Policies Tag: Visual edit
- 14:13, 3 April 2022 diff hist +1,811 N 1-18 ORGANOPHOSPHATE POISONING Created page with "Exposure to organophosphates (used as commercially as insecticides, and as nerve agents in wartimes) can cause symptoms such as salivation, lacrimation, urination, defecation, small pupils, sweating, muscle tremors and confusion. Onset of symptoms is usually within minutes. Primary endpoint of treatment is diminished airway secretions (lungs clear to auscultation), hypoxia improves, and dyspnea improves. {| class="wikitable" |'''EMR - Emergency Medical Responder''' |}..." current Tag: Visual edit
- 14:11, 3 April 2022 diff hist +103 1 - Policies Tag: Visual edit
- 14:10, 3 April 2022 diff hist +1,489 N 1-17 DISASTER SITUATIONS Created page with "'''Duties of First Responding EMS Unit''' A disaster situation is defined as multi-casualty incident that will likely tax the normal workings of the EMS system. A disaster may be called for fewer patients depending on patient acuity at the discretion of the EMS Unit in charge of the scene. In the event that an EMT-Basic unit is the first on the scene, it has EMS jurisdiction until relieved by an ALS unit. Any multi-casualty incident should require an ALS response...." current Tag: Visual edit
- 14:09, 3 April 2022 diff hist +3,556 N 1-16 NARCOTICS AND CONTROLLED SUBSTANCES Created page with "'''Medications utilized in the care of a patient:''' When a rescue squad utilizes a medication(s) they may get these restocked at any Inpatient Pharmacy at any Brown County Hospital, regardless of where the patient was delivered. This will be done by presenting to the Inpatient Pharmacy and asking a pharmacist or pharmacist tech to exchange the medication. A Pharmacy Exchange Form will be filled out including Patient Name, Date of Birth, PCR number, and medication being..." current Tag: Visual edit
- 14:08, 3 April 2022 diff hist +826 N 1-15 UNIT STAFFING Created page with "EMT unit staffing will be in accordance with state law. Continuing Educational Requirements '''EMT – Emergency Medical Technician''' EMT’s are required to meet the following CME requirements mandated by Wisconsin Statute Chapter 256.15 and Administrative Code HSS 110 for biennial re-licensure. # Biennial AHA BLS certification. Current BLS card required. # Wisconsin EMT Refresher Course. '''Paramedic''' Paramedics are required to meet the following CME requi..." current Tag: Visual edit
- 14:07, 3 April 2022 diff hist +2,066 N 1-14 PROTECTION AGAINST BLOODBORNE AND AIRBORNE PATHOGENS Created page with "All EMS providers are required to have an exposure plan in place and are expected to adhere to it. Some general guidelines are listed below. * Heavy duty leather gloves should be worn during extrication procedures to protect your hands against cuts and scratches that could become contaminated with a patient’s blood or body fluids. * Exam or surgical gloves should be worn at all times when in contact with bleeding or draining wounds, starting IV’s or childbirth situa..." current Tag: Visual edit
- 14:05, 3 April 2022 diff hist +1,793 N 1-13 PATIENT REFUSAL FOR MEDICAL CARE-TRANSPORT Created page with "If the patient refuses medical care at the scene or transport to the hospital, and in the opinion of the EMT-Basic or EMT-Paramedic team and/or the medical control physician, the patient does not have decision making capacity (i.e. drug/alcohol intoxication, medically compromised, psychotic etc.) ''and'' the patient requires immediate medical attention to prevent loss of life or permanent impairment, transport should be initiated. If necessary, the appropriate police a..." current Tag: Visual edit
- 14:04, 3 April 2022 diff hist −64 1 - Policies Tag: Visual edit
- 14:02, 3 April 2022 diff hist +64 1 - Policies Tag: Visual edit
- 13:01, 3 April 2022 diff hist +850 N 1-12 ALS INTERFACILITY TRANSPORTS Created page with "All ambulances performing interfacility transports shall have appropriate personnel, as defined by the state interfacility transport guidelines, are present on board the unit at the time of transfer. Written orders for treatment/medication to be administered while a patient is being transferred between two medical facilities should accompany the patient. The written orders should include the following: # The patient’s name, date and physician signature # The patient..." current Tag: Visual edit
- 13:00, 3 April 2022 diff hist +4,313 N 1-11 RESTRAINTS Created page with "Violent, agitated or potentially violent patients who are medically unable to give consent should be restrained on the cot to prevent injury to the patient or paramedics. If a patient is refusing treatment, but deemed to be at threat for loss of life or permanent impairment by the paramedic team, the appropriate police agency should be contacted, assist with restraints as needed and prepare an EM-1. Notify receiving hospital about the nature of the patient and the need..." current Tag: Visual edit
- 12:57, 3 April 2022 diff hist +217 N 1-10 AMPUTATED/AVULSED PARTS Created page with "Amputated or avulsed parts should be wrapped in dry gauze or Kling, placed in a sealed plastic bag or wrapped in plastic and kept cool by placing on ice or a cold pack and transported with the patient to the hospital." current Tag: Visual edit: Switched
- 12:56, 3 April 2022 diff hist +573 N 1-9 SEXUAL ASSAULT Created page with "The treatment of injuries is the primary care objective in potential sexual assault cases. Sexual Assault patients should be transported preferentially to St. Vincent Hospital for evaluation by a Sexual Assault Nurse Examiner. If the patient requests transfer to a different facility, patient choice should be honored. '''Observe the following in treatment:''' # Do not clean the patient up or allow the patient to wash # Do not question the patient concerning the incide..." current Tag: Visual edit
- 12:55, 3 April 2022 diff hist +642 N 1-8 CHILD/SPOUSE/ELDER ABUSE/NEGLECT Created page with "All suspected or actual cases of child abuse must be reported to police and/or social services by all levels of health care providers under Wisconsin Statute Chapter 48.981. In addition spousal or elder abuse should be similarly handled, although not mandatory reportable. The primary objective of pre-hospital care is transport of the victim to the hospital. Nothing should be said or done at the scene to arouse suspicions and prevent transport. A report should be made..." current
- 12:51, 3 April 2022 diff hist +3,086 N 1-7 DO NOT RESUSCITATE (DNR) Created page with "'''Purpose:''' To accurately identify patients who may not want life sustaining treatment initiated, and delineate the appropriate treatments to provide in this setting. '''Indications:''' A valid pre-hospital DNR order in the Brown County EMS system is limited to the following: # A valid state DNR Bracelet or Necklace (Plastic or Metal) # A signed standardized state DNR form (Nursing homes, CBRF, Hospice) # Direct verbal order from the patient’s primary care physici..." current Tag: Visual edit
- 12:48, 3 April 2022 diff hist +1,765 N 1-6 PREFERRED RADIO REPORTING FORMAT Created page with "'''Basic Life Support''': Identify EMS unit and that you are on a “BLS Call”. If the responding unit is a BLS unit, but the patient has symptoms that suggest the need for ALS care, this should be stated and either a request be made for ALS intercept or state that such has already been requested. The following information should then be reported: # Age and sex of patient # Chief complaint # Brief history of present illness or mechanism of injury # Level of consciousn..." current Tag: Visual edit
- 12:43, 3 April 2022 diff hist +624 N 1-5 REQUIRED MEDICAL CONTROL CONTACT Created page with "Medical control contact must be initiated as soon as patient care safely allows in the following problem categories: * Difficulty in breathing; shortness of breath * Chest pain (non-traumatic) * Dysrhythmias * Altered level of consciousness * Seizure * Syncope (age > 35) * Drug overdose-toxic substance ingestion * Acute abdominal pain with abnormal vital signs * Gastrointestinal bleeding with abnormal vital signs * Respiratory/cardiac arrest * Hypothermia, hyperthermia..." current Tag: Visual edit
- 12:42, 3 April 2022 diff hist 0 1-4 MEDICAL CONTROL COMMUNICATIONS current Tag: Visual edit
- 12:42, 3 April 2022 diff hist +1,147 N 1-4 MEDICAL CONTROL COMMUNICATIONS Created page with "There are three modalities of EMS to hospital communication: # Cellular Phone {| class="wikitable" |Bellin Hospital |433-6007 | | |- |St. Vincent |433-0312 |433-0347 |433-0459 |- |St. Mary's |498-8842 |498-1139 | |- !Aurora Bay Care Medical Center |288-4070 |288-4068 | |} 2. UHF Frequency {| class="wikitable" |Bellin Hospital |Med Channel 6 or 7 |- |St. Vincent |Med Channel 7 |- |St. Mary's |Med Channel 8 |- |Aurora Bay Care |Med Channel 6 |} 3. VHF Frequency of 155.3..." Tag: Visual edit
- 12:35, 3 April 2022 diff hist +1,756 N 1-3 ALS INTERCEPTS Created page with "'''Purpose:''' To assist EMS providers operating at the BLS level in the provision of more advanced care to appropriate patients in a timely fashion’ Indications: The primary responsibility of calling for an ALS intercept lies with the EMS unit currently providing care to the patient. The decision to request ALS intercept may be made either on receiving the initial EMS call or after the provider’s initial evaluation. Conditions which should prompt an early request f..." current Tag: Visual edit
- 11:55, 3 April 2022 diff hist +5,982 N 1-2 HOSPITAL DESTINATION Created page with "'''General:''' The patient should be transported to the area hospital with an emergency department of the patient’s choice. In the event the patient is unconscious, the family’s wishes should be respected. If questioned about available institutions, all four available hospital emergency departments in Brown County should be offered. If the patient has no preference, they should be transported to the closest emergency department. If there is a known incident or in..." current Tag: Visual edit
- 11:54, 3 April 2022 diff hist +1,719 N 1-1 PHYSICIAN ON-SCENE Created page with "When a physician is present at the scene and offers their assistance, please inform the physician of the following policy: “Thank you for your offer of assistance. Be advised these EMT’s are operating under the authority of Wisconsin Statute Chapter 256.15 No physician or other person may intercede in patient care without the medical control physician on duty relinquishing responsibility of the scene via radio or telephone. If responsibility is given to a physicia..." current Tag: Visual edit
- 11:50, 3 April 2022 diff hist +761 N 2 - Adult Medical Created page with "2-1 ASYSTOLE/PEA 2-2 ADULT CARDIAC ARREST: CARDIO-CEREBRAL RESUSCITATION 2-3 ADULT CARDIAC ARREST: CEREBRAL COOLING PROTOCOL 2-4 UNSTABLE TACHYCARDIA 2-5 STABLE TACHYCARDIA 2-6 BRADYCARDIA (SYMPTOMATIC) 2-7 MEDICAL HYPOTENSION / SHOCK 2-8 ACUTE ST ELEVATION MYOCARDIAL INFARCTION 2-9 ADULT CHEST PAIN 2-10 ACUTE CVA (STROKE) 2-11 ACUTE ALLERGIC REACTION 2-12 RESPIRATORY DISTRESS 2-13 ABDOMINAL/BACK PAIN (SUSPECT..." Tag: Visual edit
- 11:46, 3 April 2022 diff hist +72 1 - Policies Tag: Visual edit
- 11:44, 3 April 2022 diff hist +598 N 1 - Policies Created page with "1-1 PHYSICIAN ON-SCENE 1-2 HOSPITAL DESTINATION 1-3 ALS INTERCEPTS 1-4 MEDICAL CONTROL COMMUNICATIONS 1-5 REQUIRED MEDICAL CONTROL CONTACT 1-6 PREFERRED RADIO REPORTING FORMAT 1-7 DO NOT RESUSCITATE (DNR) 1-8 CHILD/SPOUSE/ELDER ABUSE/NEGLECT 1-9 SEXUAL ASSAULT 1-10 AMPUTATED/AVULSED PARTS 1-11 RESTRAINTS 1-12 ALS INTERFACILITY TRANSPORTS 1-13 PATIENT REFUSAL FOR MEDICAL CARE/TRANSPORT 1-14 PROTECTION AGAINST BLOODBORNE AND AIRBORNE PATHOGENS 1-15 UNIT STAFF..." Tag: Visual edit
- 11:42, 3 April 2022 diff hist −57 Main Page Tag: Visual edit
