General
Target oxygen saturation (SpO2)
90-94%
(Exception: Ventilator Malfunction - Family Centered Care AND Drowning/Submersion)
The dose of aspirin a provider gives when the patient has already taken their daily dose
The full 325 mg (or 81 mg baby aspiring x4)
Dose of IM Epi 1:1 for adult patients having an allergic reaction
0.5 mg
Certification required for Needle Thoracostomy
Paramedic
Two diagnostics a provider should obtain immediately after obtaining ROSC
12-Lead EKG and BP
Yellow Tagging - When performed, for which compartments, and what a provider's initials mean on it
After every call for any compartment that was opened
Initials indicate that the provider has verified that whatever was used from that compartment has been replaced
This airway device is preferred in pediatric patients, even in long transport.
BVM Ventilation
How often the provider should take a 12-lead EKG in patients with cardiac chest pain (in transports more than 15 minutes... which is all of them)
Dose of Midazolam for combative adult patients
5 mg, can repeat ONCE after 10 min
Target Systolic BP in Head Injuries
110 mmHg
The total number of Epi 1:10 doses to be given to a patient WITHOUT a clear, observed response to epinephrine
3 doses
Exceptions to being present for Bay Work
Provider has been on a FULL transport (to hospital and back) at some point between 3-8 AM
Provider is currently on a call when Bay Work is being performed
The number of attempts providers can attempt ET Tube placement
One
S/S of Symptomatic Bradycardia
Hypotension, Signs of Shock, and AMS
Route of overdose with highest probability of re-sedation post naloxone administration
Oral
When a patient is bleeding from an extremity, the provider should
For an immediate family member to have the authority to terminate resuscitative efforts, all of the following criteria must be met...
-The patient has a known chronic/terminal illness
-All relatives on scene fully agree
-All EMS personnel on scene fully agree
-OLMC concurs
The frequency with which Daily Bay Tasks are to be completed
D.A.I.L.Y.
These medications allow only a SINGLE dose
Acetaminophen, Ibuprofen, and Ketorolac
Preferred medication in managing cardiac chest pain (ACS)
Fentanyl
Rewarming a patient in cardiac arrest due to hypothermia: Yes or No
NO
Avoid over-tightening as this can cause increased ICP
If newborn is apneic, slow to respond, has slow or gasping respirations, or persistent central cyanosis...
In the first 30 seconds, the provider should...
Warm, dry, and stimulate the baby. Consider suctioning the MOUTH then NOSE with bulb syringe.
Red Tagging - When performed, for which compartments, and what a provider's initials mean on it
Every Day for all compartments with a yellow tag or no tag.
Initials indicate that the provider has been through the compartment and verified that all required materials and their amounts are present
In shock protocol, Push-Dose Epi and Epi Drips can be given under this/these circumstance(s)
Non-Traumatic Shock ONLY
Dose of Atropine in bradycardic adult patients, then pediatric patients
Adult: 1 mg, q3min PRN, up to 3 mg total
Pediatric: 0.02 mg/kg, max single dose 0.5 mg, q3-5min PRN, 1 mg max total (child) or 2 mg max total (adolescent)
Dose of Ketamine for combative patients
IM - 4 mg/kg ONCE
IV/IO - 1 mg/kg ONCE
Ventilatory rates of Therapeutic/Mild Hyperventilation
~10% above normal target RR
List all H's and T's (According to AHA Guidelines)
Hypovolemia, Hypoxia, Hydrogen Ions (Acidosis), Hyper/Hypokalemia, Hypothermia
Tension Pneumo, Tamponade, Toxins, Thrombosis
The appropriate time to get a transporting patient's signature
Prior to start of transport
The medications used in pain management and their maximum overall dose (Hint: there are only 3 medications)
Morphine - 15 mg
Fentanyl - 200 mcg
Ketamine - 40 mg
Initial energy for cardioversion in adults, then in pediatrics
Adult: 100 J, Repeat doses 200 J
Pediatric: 0.5-1 J/kg, Repeat doses 2 J/kg
When face of neonate presents, nose and mouth are suctioned: Yes or No?
NO
IV Fluid Therapy totals for Adult and Pediatric Burn Patients
Adult and Ped >13 yrs: 500 cc/hr
Ped <5-13 yrs: 250 cc/hr
Ped <5 yrs: 125 cc/hr
*If 2nd/3rd Degree >10% BSA and/or Electrical
If newborn is apneic, slow to respond, has slow or gasping respirations, or persistent central cyanosis...
If no change in first 30 seconds or HR <100 bpm, then in the second 30 seconds, the provider should...
Perform 30 seconds of PPV w/ BVM at a rate of 40-60 bpm.
Ounces of Odoban per 1 gallon of hot water
5
A Fluid Bolus should ONLY be given when Systolic BP is under this threshold range
80-90 mmHg
Indication for Adenosine
Indicated for patients with prior SVT who have responded to adenosine previously
Patients whom EMS are REQUIRED to transport to the hospital, no matter the patient's desires
Suicide threat/attempt
Alert and Oriented x 3 or less out of 4
Unemancipated Minors whose Parent/Guardian/In Loco Parentis is not present and cannot be contacted
TXA Protocol
Hemorrhage (including post-delivery OB patients) - 1 g IV bolus IF WITHIN 3 HOURS OF START
Target oxygen saturation (SpO2) in newborn resuscitation AND minimum BGL before treatment is necessary
80-90%
30 mg/dl
Patients who should never be taken to Mountain West
Those involved in an MVC
This protocol should never be used concurrently with pain management protocol
Agitated/Combative Patient Protocol
Certification level of a provider who can use Push-Dose Epi and when they have to consult OLMC prior to administration
Paramedic and literally every time for every protocol
All Medications that can be used for patients in Respiratory Distress
Basic - Oxygen
AEMT - Albuterol, Ipratropium, Epi 1:1 (IM and Neb)
Paramedic - Mag Sulfate (IV), Lidocaine+Albuterol (Neb)
Respiratory and/or Cardiac Arrest
Pediatric Lowest Acceptable Systolic BP (1 mo, 1 yr, <10 yrs, >10 yrs)
1 mo - 60
<1 yr - 70 mmHg
<10 yrs - 70 mmHg + (Age x 2)
>10 yrs - 90 mmHg
White Tagging - When performed, for which compartments, and what a provider's initials mean on it
Biweekly (as shown on calendar) on every compartment, tagged or not
Initials indicate that the provider has been through the compartment and verified that all required materials and their amounts are present and unexpired
When faced with a patient in pain who is also experiencing intense anxiety, the provider should...
Treat pain fully with analgesics ALONE before using sedatives concurrently
Medications for use in known/suspected hyperkalemia
Calcium Chloride and Sodium Bicarbonate (Calcium Gluconate can be used but we won't be carrying it)
Definition of SLUDGEM
Salivation, Lacrimation, Urination, Defecation, GI Cramping, Emesis, Miosis
TEN-4 Rule (Non-Accidental Trauma/Abuse)
Children 4 yrs and younger w/ bruising to Torso, around Ears or Neck must be reported.
If newborn is apneic, slow to respond, has slow or gasping respirations, or persistent central cyanosis...
If no change after the second 30-second set or newborn HR <60 bpm, then in the third 30-second set, the provider should...
Begin CPR with a breath/compression ratio of 1:3
Three reasons why your ePCRs are required to be finished within 24 hours post-call
It is a medical record and must be accessible to pertinent healthcare personnel within 24 hrs
It can be used as a legal document. ePCRs that are incomplete or have a delayed completion date are considered less reliable in court
Billing reasons. Which we all know.