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MCEMS protocols

ems protocols

Drip equation? amount infused in ml x drip set/time in min=gtts/min.
med equation Dose ordered/dose on hand x volume=
age parameter adult 13 and older.
age parameter child 12 to 1 year old
age parameter infant 11 months to 1 month
Neonate parameter less than 1 month.
adult fluid challenge 200-500ml with 1 repeat dose.
Child fluid challenge 20ml/kg
newborn fluid challenge 10ml /kg
aspirin dose 324 mg
Altered loc ABC's+fix,disability,ecg,decision about destination.hx, assessment, vs+bg+sao2+.Tx:Iv,o2,monitor, bolus , glucose for low bg, narcan for narc overdose.
EPI adult dose: severe anaphylaxis severe reaction. 1:1000 =0.01ml/kg max o.3ml sub q if no iv in place. 1:10,000 0.1ml/kg max 0.3 sivp and repeat prn every 5 min.
EPI adult dose: Mild anaphylaxis 1:1000 epi sub q @ 0.01ml/kg, max 0.3ml repeat every 15 minutes. true or false True.
Epi adult dose : Asthma 1:1000 epi @ 0.01ml/kg sq.
Epi adult dose: cardiac arrest 1 mg iv/io or 2mg et every 3-5 min.
Epi adult dose: Unstable bradycardia. 2-10mcg/min addmixture 1mg in 250 ml ns= 4mcg/1ml
Syringe pump Amiodarone. 150 mg over 10 min, concentration 150/ 50ml, 3mg/ml.
Syringe pump Dopamine. 5-20 mcg/kg/min, concentration 400 mg/250 ml, 1.6 mg ml.
Syringe pump Epinephrine adult. 2-10 mcg/minute, 1mg/250 ml, 0.004 mg/ml.
Syringe pump Epinephrine pediatric. 0.1 to 1mcg /minute, 1mg /250 ml, 0.004 mg/ml
Syringe pump Lidocaine 2-4 mg/minute, 2 grams in 250 ml, 4mg/ml.
Syringe pump Lidocaine pediatrics. 20-50mcg/kg/min, 60mg/50ml, 1.2mg/ml
Syringe pump mag sulfate. 1-2 g over 10 min, 1-2 g/50ml, 20-40 mg/ml
Syringe pump Nitroglycerin. 5-50mcg/min, 25mg/250ml , 0.1mg/ml.
Syringe pump levophed 2-20 mcg/min, 4mg/250ml, 0.016mg/ml
Syringe pump levophed peds 0.05-0.1 ml, 4mg/250ml, 0.016mg/ml
General Medical Protocols Bsi, scene safety,Abc's,Disability,hx,secondary assessment,vs, iv ,o2 monitor,fix it when you find it.
Acute coronary syndrome. Bsi, scene safe, Abc's, disability, hx,secondary assessment, vs, 4 lead, 12 lead ,labs drawn, 324 mg asa, iv, nitro x 3, fentanyl( 200 mcg max) or morphine ( 2/10mg)for pain.
Nitro drip 25 mg/250 ml, 100 mcg/ml, see drip card. watch pain level changes, ecg changes, and vs changes,
Asystole, PEA. Bsi, Scene safety,Abc's,ccr/cpr. iv/io, 1mg epi,0.1ml/kg peds q 3-5 min,250-500 ml bolus, early pacing
vfib, pulseless vtac. bsi,scene safe,witnessed arrest 200 joules, 2 j/kg ped, Abc's, ccr/cpr.Iv/Io, 1 mg epi, 0.1ml/kg peds q 3-5 min, 300 mg iv/io Amiodarone, or 1-1.5 mg/kg lidocaine. Amio 150 second dose, lido .5-.75.Mag sulfate 1-2 gram iv/io for refractory vf/vt, peds .
Bradycardia. Bsi,scene safe, ABCd, hx, assessment, vs, iv/io/ 02, monitor, pacing, atropine .5 mg q-3 to 5 min to 3 mg/kg max. Peds epi o.1 ml kg 1.10,000, then 0,02mg/kg atropine.
Bradycardia epi infusion. Start infusion at 2mcg/min, or 30 ml an hour rate not to exceed 10 mcg/min, 1mg/250 ml= 4mcg/ml conc.
Bradycardia sedation and analgesia dose. 2-5mg versed adult ,0.1 mg/kg pediatric. 1-2 mcg/kg fentanyl for analgesia.
Tachycardia arrhythmia narrow regular complex . Bsi,scene safe,ABCD,hx,assessment ,vital signs, Iv,02,monitor.Sedation, unstable pt's cardioversion, adenosine 6mg,12mg,12mg. No conversion cardizem 0.25mg/kg repeat at 0.35mg/kg.
Tachycardia arrhythmia synchronized cardioversion doses. Afib, or stable monomorphic v-tac at 100,200,300,and then 360 j.Svt or atrial flutter start at 50 j.Polymorphic vtac treat as vfib. Peds at 0.5 to 1.0 j /kg and increase to 2j/kg
Tachycardia arrhythmia narrow complex irregular. Bsi, scene safe, ABCD, hx, assessment, vs,iv, o2, monitor, cardiovert unstable afib at 100,200,300,360, aflutter at 50.
Tachycardia arrhythmia wide complex regular. Bsi.scene safe,ABCD,hx,assessment,vs,iv,02,monitor,cardiovert unstable at at 100,200,300,360 j.Stable amiodarone at 10mg over 10 minutes.
Tachycardia arrhythmia cardizem drip after successful bolus conversion. 10mg/hr, 1mg/ml equals 10ml/hr.
Cardizem bolus dose 0.25mg/kg, next 0.35/kg.
Created by: rglossip