medical first responder program · version 2 – printed 9/19/2015 contraindications - bp < 100...

Medical First Responder ProgramProtocols

Medical Scene Safety Protocol

Scene Safe? Enter

Possible to Make Safe

Exit Area and Stage

Outside Agencies Needed

Contact Agency and Wait

Contact EMS with Update

YES

NO

NO

YES

Continue to Appropriate Protocol

Make Safe Then Continue

YES

Stay StagedNO

Document Time and Events Version 2 – Printed 9/19/2015

Verify Scene Safety with Police or

DispatchUNKNOWN


Chest Pain Protocol

Pt. C/O Chest Pain

100% O2 via Nasal Cannula

(4 lpm)

Is Pain Suggestive of Cardiac / Heart Pain?

(no change on movement, deep breaths or palpation)

Continue with treatment and update EMS

Give 2 X 80mg Chewable ASA if no

contraindications

EMS On-Scene

NO

YES

Contraindications

- Asthma- Allergic to ASA

- Recent Significant Bleeding

Obtain Vital Signs

Contact with Update

Recheck Vitals q5min

NO Assist EMSYES

Document Time and Events

-Pt. Supine position

Assist w/ Patient Medication. Max

3 Doses Nitro

Version 2 – Printed 9/19/2015

Contraindications

- BP < 100 Systolic- Pulse < 60 bpm

- Viagra/Levitra < 24 hrs- Cialis < 48 hrs

6 Rights of Medication

Right PersonRight MedicationRight DosageRight TimeRight RouteRight Documentation(Time, dose, route, effect)


Anaphylaxis Protocol

Pt. Presents with Severe Allergic

ReactionPt. In Respiratory DistressPlus one of the following

-Hives- Tongue Swelling-Throat Swelling

-Previous Reaction100% O2 via NRB

(10-12 lpm)

Pt. > 12 y/o

Prepare EPI-PEN Jr.

PrepareEPI-PEN

6 Rights of Medications

Remove Safety Cap

Place injection tip against outer thigh & push auto injector firmly

against thigh – quick motion

You should hear a click, hold for 10 sec

Remove epinephrine auto-injector and send to hospital w/ patient.

Monitor ABC’s and Vitals

Update EMS until arrival

YESNO

Epi PenAvailable?

YES

NO





Diabetic Reaction Protocol

Pt. conscious and known

diabetic

Primary and Secondary

Survey plus Vitals

Patient is diabetic symptoms and/or states they feel like their sugars are low

Give pt. half tube of oral glucose, sugar and water or something sweet

to eat or drink

***gag reflex must be present


Update EMS

Monitor ABC’s and Vital Signs

Go to appropriate protocol

NO

YES



Provide Oxygen


Cardiac Arrest Protocol

Patient Presents with No Pulse and No Respirations

Start CPR

Pt. > 8 y/o

Attach Adult Pads

Attach Pedi Pads if available, if not use Adult/Child

Pads

Shockable RhythmNon-Shockable

Rhythm

Clear pt.- ANALYZE1 Shock

** Only 1 shock if pt. Hypothermic/ check

pulse for 45 sec.

Immediately Resume CPR

30:2* for 2 Min

Repeat Steps till EMS arrives or

No Shock Indicated

Immediately Resume CPR

30:2* for 2 Min

Repeat steps until EMS arrives

or Shock Indicated

YES

NO

Defibrillator Available?

YES

Continue CPR and Update EMS

NO


Assess RhythmShock Advised?

YES NO

*PLEASE NOTE

Child & Pediatric CPR cycle consists of 30 compressions (1 rescuer) or 15 compressions (2 rescuers) per 2 breaths

Pt > 1 y/o

CPR30:2*

Continue CPR until EMS arrives

NO

YES


Do Not Resuscitate conditions met?

Suspend treatmentUpdate EMS

YES NO


Respiratory Arrest Protocol

Pt. presents not breathing

Airway Opened with appropriate maneuver

Breathing Absent?

Pt. tolerates OPA?

Continue with Primary Survey

Continue with Manual Airway

Technique

NO

YES NO

Attempt to ventilate X2

Air Goes In?Go to Choking

protocolNO

Check if pulse present

Insert OPA

Does Pt Tolerate OPA?

Goto Cardiac Arrest Protocol

Continue with Manual Airway

Technique

Ventilate PtAdult- every 5

secChild- every 3

sec

Update EMS

YES

NO

YES

YES

NO

YES

Check for pulse after 1 min and every few minutes




Choking Adult/Child Protocol

Pt. presents with signs of choking

Pt. unable to breath, cough or speak?

Encourage pt. to continue to

cough

Deliver 5 back blows / 5

abdominal thrusts

Airway cleared?

Pt. conscious?

Lower pt. to ground

Monitor ABC’s and check vital

signs

NO

YES

YESYES

NO

Tongue jaw liftLook into mouth

Finger sweep only if FBAO

visible

Tongue jow liftLook into mouth

Finger sweep only if FBAO

seen

ADULT CHILD

Start CPR

FBAO Relieved?

Goto Resp arrest protocol

Start CPR

FBAORelieved?

Pt Breathing on own?

Monitor Vital Signs and ABC’s

YES YES

YESNO

NO

Update EMS


NO

NO



Choking Infant Protocol

Infant < 1yr presents unable

to breathe, cough or cry

Conscious?5 chest

compressions with 2 fingers

5 back blows

Repeat until FBAO is relieved

or pt. goes unconscious

Look into mouth and sweep only if

FBAO seen

Position head in sniffing position

and ventilate

Air goes in?

Give 30 chest compressions with 2 fingers

Give 2nd breath

Check Pulse

Is there a pulse?

Goto Cardiac Arrest protocol

Is pt. breathing on

own?

Goto Respiratory Arrest Protocol

Monitor ABC’s and Vital Signs

Update EMS

YES NO

NO

YES

NO

YES

NO

YES




Do Not Resuscitate Protocol

Patient presents in Cardiac Arrest

Are any of the following circumstances

present:- DNR order present signed by Doctor?

- Decapitation?-Rigor Mortis?

-Lividity?-Gross Evisceration?

-Incineration?-Transection?

-Decomposition?

Do Not Resuscitate or Cease resuscitation efforts

Go to Cardiac Arrest Protocol

YES

NO

Update EMS




Trauma with Suspected C-spine Injury Protocol

Mechanism of Injury suspect of

c-spine injury

Scene Safe/Stable?

Prepare for Emergency Rapid

Extrications

Manual c-spine taken by one

rescuer

Pt. placed on long spine board

Pt. moved to safer location

Manual c-spine taken by one

rescuer

Second rescuer complete primary

and secondary survey

Update EMS

EMS Request pt immobilization

Continue to hold c-spine until EMS

arrives

With c-spine held move pt. onto

long spine board

Strap patient’s body to long spine board

Put on head immobilizers and

secure head

Monitor Vital Signs and ABC’s

Update EMS

NO

YES

NO

YES

Document Timeand Events



Opioid ProtocolPt. Presents

unconscious & not responding to

verbal stimuliPt. In Respiratory DistressNo detectable breathing or

poor respiratory effortEvidence of Opiate use

Known Naloxone

AlergyPrepare syringe, Draw entire vial

of Naloxone. Depress plunger

to remove air.

Place patient in recovery position

Inject at 90o angle into shoulder or thigh.

Repeat in 3-5 minutes if no or minimal responsiveness.

Send used kit to hospital w/ patient.


Update EMS until arrival

YES

NO

Naloxone Kit Avaialable?

YES

NO



Bystander InformationDrug ParaphernaliaKnown HistoryPinpoint PupilsOther Opioid use indications

**PATIENT MAY RESPOND

VIOLENTLY**

6 Rights of Medications

Approved and Added Oct 19/2017

medical first responder program · version 2 – printed 9/19/2015 contraindications - bp < 100...

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