WMA WFR Protocals
Anaphylaxsis
What is
IM epinephrine 0.01mg/kg body weight up to 0.5mg for adults. Consider fixed dose auto-injectors. Repeat as soon as 5 minutes as needed.
oral antihistamine
40-60mg prednisone
monitor for worsening conditions
RICE
Rest
Ice
Compression
Elevation
Asthma Treatment
PROP, assist with inhaler, consider Epi
Lightning Drill
What is
Seek low risk area for shelter, spread out group, insulate from ground with sleeping pad squatting or sitting
Tick Paralysis Treatment
What is
Remove the tick
Wound Cleaning and Debridement
What is
Wash skin around wound with soap and water
except for punctures, irrigate all other wounds with water under pressure
pick out foreign material
high risk wounds
-1% povidone iodine irrigation
consider antibiotics
Remove all impaled objects EXCEPT- impaled in the globe of the eye, removal would result in serious bleeding, pain, or injury
What is
Long bone fractures should be splinted in anatomic position. Use traction into position (TIP)
Stop TIP if increase in pain, or resistance is met
Long bone and joint injury- stabilize above and below bone
well-padded, light, adjustable, and multi-directional
monitor CSM before and after
What is
fever, dehydration, persistent vomiting, diarrhea, blood in vomit/stool, abdominal trauma, persistent pain, tenderness, pregnancy, altered mental status
HACE
What is
high altitude cerebral edema
AVPU
Awake/Alert
Verbal
Pain
Unconscious
CPR
What is
Only applies to normothermic patients (core temp above 90F)
CPR will not be started or may be discontinued after initation in these cases
1. Cardiorespiratory arrest after submersion in water for more than one hour in the absence of a source of air such as SCUBA equipment or an air pocket.
2. Obvious lethal injury such as decapitation, exsanguination, or massive head injury.
3. Where cardiac arrest persists continuously for over 30 minutes of sustained CPR.
4. Where rescuers are at risk of injury or death.
Stable vs Unstable Injury
Stable- can put weight on it
Unstable- cannot put weight on it, needs evac
STOPEATS
What is
Sugar
Temp
Oxygen
Pressure/Perfusion Pressure
Electricity
Altitude
Toxins
Salts
Heat Stroke vs Heat Exhaustion
What is
exhaustion- fatigue resulting from physical stress in a hot environment, sometimes precedes heat stroke, can be associated with dehydration
stroke- sever, life-threatening rise in body temperature which may or may not be preceded by heat exhaustion, The body is producing more heat than it can "dump" through evaporation and other cooling mechanisms
Where to take a patients pulse
What is
at the wrist thumb side or if cannot use this
jugular vein on the neck
Spine Injuries
What is
Assess the mechanism. If a positive or uncertain mechanism exists, protect the spine from further trauma by whatever method is feasible and available.
2. Do a thorough evaluation including a history and physical examination. To clear the spine, the patient must meet all of the following criteria: a) Patient must be reliable, cooperative, sober, and alert. b) Patient must be free of spine pain and tenderness. c) Patient must have normal motor/sensory function in all four extremities: Finger abduction or finger or wrist extension against resistance (check both hands) Foot plantar flexion/extension or great toe dorsiflexion (check both feet) No complaint of numbness and sensation intact to sharp and dull stimuli in all four extremities If reduced function in one particular extremity can be attributed with certainty to a specific extremity injury (e.g., unstable wrist injury), that deficit alone will not preclude ruling out a spine injury.
3. If the spine cannot be cleared, spine injury remains on the problem list and must be appropriately managed and followed up as part of patient care and evacuation. This may include stabilization and carry, assisted self extrication, or other means of reducing the risk of further injury pending medical evaluation and treatment.
Severe Bleeding Control
What is
Find bleeding-survey scene, glove and eye protection on
expose area, visualize wound
Control Bleeding- well-aimed direct pressure; pack deeper wounds, pressure dressing, hemostatic dressing may help
Tourniquet- apply to bare skin at least 5cm above the site to control bleeding and stop distal pulse, "high and tight"
consider loosening after 1 hour if bleeding has stopped. If bleeding resumes, reapply, note the time and leave in place
do not loosen or remove tourniquets when there is an amputation, shock, or wound cannot be visualized and monitored
Diabetes Define
What is
Diabetics do not produce enough insulin to balance the sugar/energy needs of their bodies. Some must take insulin, others control with diet.
Heat Stroke Treatment
What is
Aggressive cooling! Cool water immersion or evaporative cooling technique, volume replacement, ALS evacuation, especially if MS does not return to normal after cooling, or red/brown urine or sever muscle pain develop.
SAMPLE
What is
Symptoms
allergies
medications
past history
last
events
Joint Dislocations
What is
This protocol specifically applies to the reduction of dislocations of the shoulder, patella, and digits. These injuries are usually isolated, not accompanied by significant critical system injury, and caused by an indirect mechanism. All other dislocations should be treated as unstable joint injury and splinted in a position that maintains stability and neurovascular function while facilitating transport.
Burns
What is
stop burning (cool H2o), pain medications
Chemical burns- stop burning: wash off wet; brush off dry. pain medications
Clean-sterile h2o
debridement
antibiotic ointments
dress with non-stick gauze, elevate
minor burn- monitor for infection major- evac
Hypoglycemia vs hperglycemia
What is
Hypo- caused by imablance of supply and demand (ie not eating enough) insulin usually ok, can be occasionally caused by too much insulin
Hyper- insufficient insulin levels, too much food intake for the amount of work, significant dehydration, electrolyte imbalances, body resorts to alternative fuel sources
Snake Envenomation Treatment
What is
remove constricting articles, clean area, dress wound, evacuate to facility with antivenom,no need to kill snake
Vital Signs
What are
pulse
respirations
skin temp
blood pressure
oxygen saturation
AVPU