Medical
Trauma
Respiratory
Procedures
Medications
100
Two drugs for sedation for Excited Delerium - Extremely Agitated Patient
If sedation needed, use Ketamine (4mg/kg) or Midazolam (heavy dose - 5mg)
100
The most restrictive method of spinal restriction.
Backboard
100
Titrate to resolution of respiratory depression rather than full available dose.
Narcan
SMO also allows for use of high dose IN (4mg/ml)
Patients with decisional capacity may refuse, advise and document risk. Consider contacting Medical Control.
100
Standard Fluid Bolus amounts
Adult: 250mL Pediatric 20ml/kg
Except burn support fluid rates (see SMO)
100
New medication for mild to moderate pain and/or fever
Tylenol OTC
EMT-Bs can administer.
200
New system approved stroke assessment scale
G-FAST Screen:
GAZE DEVIATION: Does the person stare to one side and cannot move their eyes back to center.
FACIAL DROOP: Ask the person to smile and/or show their teeth.
ARM DRIFT: Ask the person to hold both arms out in front of them for the count of 10.
SPEECH: Have the person say a sentence (example: You can’t teach an old dog new tricks).
200
Needle decompression locations
Second intercostal space mid-clavicular and fifth intercostal space mid axillary.
Must use system approved device.
200
What procedure is indicated for CHF/Pulmonary edema?
CPAP
200
This 12-lead procedure is now optional.
Right sided 12-lead in inferior MI.
200
New procedure/medication to consider for nausea
Isopropyl Alcohol Wipe
300
Alternative to Epi-Pen that EMT-Bs can administer for anaphylaxis.
IV Epi
Also indicated in refractory bronchospasm, caution in patients with cardiac histories.
300
Indications for TXA (indication and criteria)
High risk for ongoing internal hemmorage and systolic BP <100 OR tachycardia >110, including uncontrolled post-partum hemorrhage and abruption placenta
Contraindications
Injuries >3 hours, Pediatric patients, disseminated intravascular coagulation
300
Blood pressure condition related contraindication for CPAP
hypotension
300
What medication could be considered for tall peaked T waves
Calcium Gluconate (Hyperkalemia)
300
This medication, indicated in the previous SMOs to support/increasing blood pressure, was removed and replaced with Epinephrine and Norepinephrine.
Dopamine
Norepinephrine Used in SMO:Bradycardia,Cardiac Arrest Post Resuscitation (ROSC), Sepsis, Shock/Traumatic Hemorrhage/ Wound Packing
Epinephrine Used in SMO: Bites, Stings, and Envenomation, Cardiogenic Shock
400
Secondary medication for polymporphic VT and Torsades
Magnesium Sulfate (see table in SMO)
400
Medication indicated for crush injuries/suspension trauma
Sodium bicarb
Also cardiac arrest, metabolic acidosos, hyperkalemia, and tricyclic antidepressant overdose
400
Medications for bronchospasm/wheezing (name 3)
Duoneb/Albuterol, Methylpredisone, Magnesium Sulfate, Epinephrine
400
This medication is no longer approved for MAD (IN) delivery.
Morphine
Medications that can be given IN are Nalaxone, Midazolam, and Fentanyl
400
New medication for pediatric upper airway distress (stridor, croup)
Racemic epinephrine
500
Common cause of hyperkalemia
Renal failure, dialysis
Consider calcium gluconate
500
Can be used to stabilize pelvic area in blunt and blast injuries
Pelvic binder
500
Temp > 100.4 and signs of infection OR Temp < 96.8 and signs of infection consider this condition
Sepsis
500
New site for IO access
Distal Femur - 4cm proximal to the patella, midline and perpendicular.
500
Dose of Nitroglycerine for syptomatic Pulmonary Edema and systolic BP >160.
Double initial dose (2 tablets), up to three additional double doses. Lasix no longer indicated in PE, removed from SMOs.