2008 Mercy Protocols Changes

Page 7 Aeromedical Helicopter

Changes in Landing Zone requirements and Aeromedical Use Guidelines.

Page 13 NOTIFICATION OF SPECIAL PROCEDURES

Changes in notification items and updates contact info.

Page 17 Cardiac A CARDIAC ARREST PROTOCOL

CPR Changes, and New Defib energy levels for various types of defibrillators.

Page 19 Cardiac B-VENTRICULAR FIBRILLATION

New ACLS Protocol with Vassopressin first and ResQ Pod. Newer ET Meds list. If pt
down time greater than 4 minutes do CPR for 2 minutes then first DEFIB.

Page 21 Cardiac C- Pulseless Electrical Activity

Changes in ACLS Protocol, Vassopressin first (is identical to asystole protocol)

Page 23 Cardiac D Asystole

Changes in ACLS Protocol, Vassopressin first, No pacing (is identical to PEA
protocol)

Page 26 Cardiac G- BRADYCARDIA PROTOCOL

Epi drip changes to correct math error, Atropine max 3mg, sedation changes,

Page 28 Cardiac H Third degree block

Epi drip changes to correct math error, Atropine max 3mg, sedation changes,

Page 30 Cardiac G- PSVT

Adenosine 6mg then 12mg then move to Cardiazem if narrow and amiodarone if
wide complex. Sedation changes

Page 34 Cardiac N-1, ACUTE CORONARY SYNDROME

Four 81mg Aspirin, Morphine and Fentanyl dosage changes. EMT Intermediates
May use Nitro SL, Nitro drips for approved sites with infusion pumps

Page 35 Cardiac O Acute Pulmonary Edema

Four 81mg Aspirin, Morphine and Fentanyl dosage changes. EMT Intermediates May
use Nitro SL, Nitro drips for approved sites with infusion pumps. Lasix dose reduced

Page 41-44 Medication Infusion Protocols

Changes for Nitro drips, add natrecor, epi dopamine cardiazem drips ok for
interfacility transports. Concentrations at Mercy Pump standards. Exclusion list
denoted. This is for Lifestar Interfacility transports mostly.

PAGE 57-58 Medical Emergencies A Altered mental States

EMT Intermediates May use Benedryl, Narcan, Glucagon, D50
Blood sugar < 60 mg/dl or if blood sugar < 80 mg/dl and patient has signs and symptoms of If
hypoglycemia, administer one amp 50 ml of 50% Dextrose IV push
If no IV can be established administer 1 unit Glucagon IM.
****Above May be given by Authorized EMT-Intermediates****

PAGE 59-60 Medical Emergencies a-1

Poisonings

EMT Intermediates May use Benedryl, Narcan, Glucagon, D50

PAGE 61-64 Medical Emergencies C SEIZURES, SYNCOPE

EMT Intermediates May use Glucagon, D50

PAGE 65-67 Medical Emergencies E Asthma and F Allergic

Reactions
EMT Intermediates may use Epi, Benedryl, Aeresols

PAGE 68 Medical Emergencies G CVA

EMT Intermediates May use Glucagon, D50

PAGE 70 Medical Emergencies I Abdominal Pain

Phenergan deleted, Zofran added/ COMPAZINE ,

PAGE 71 Medical Emergencies J Cyanide Poisoning

Hydroxycobalamin (Cyanakit) added, amyl nitrate limited, sodium thiosulphate
deleted

PAGE 72-73 Medical Emergencies K-2 Hypertensive crisis

Lopressor one dose without med control order.

PAGE 76 Medical Emergencies I VOMITING

Phenergan deleted, Zofran added/ COMPAZINE ,

PAGE 77 Medical Emergencies COPD.

Intermediates can give aerosols
For third aerosol may be given, mix 1unit dose of Albuterol and 1 unit dose of
Atrovent

PAGE 80-81 PEDS RESP DISTRESS .

Intermediates can give aerosols

PAGE 82 PEDS ASTHMA .

Intermediates can give aerosols

PAGE 83 PEDS ALLERGIC Allergic Reactions

EMT Intermediates may use Epi, Benedryl, Aeresols

PAGE 99 PEDS SEIZURES

EMT Intermediates May use Glucagon, D50

PAGE 100 PEDS POISONS

EMT Intermediates May use NARCAN Glucagon, D50

PAGE 115 TRAUMA EXT TRAUMA

PAIN meds changes to include IN new dosages Fentanyl Morphine

PAGE 117 TRAUMA Burn

PAIN meds changes to include IN new dosages Fentanyl Morphine

PAGE 123 Hyperthermia

EMT Intermediates May use Glucagon, D50

PAGE 131 Procedures RSI

New dosages meds

PAGE 138 Procedures Needle decompression

Correct placement 4th 5th intercostal space. EMT I allowed

PAGE 142 Procedures I/O

Policy revised Fast 1, EZ IO

PAGE 145 Procedures Alternate IV Use

Policy revised need chlorohexadine swabs, saline locks allowed.. get pre-filled
saline syringes

PAGE 153 Procedures resqpod

Policy revised

PAGE 154 Procedures Fast 1

Policy revised
Need to develop KING LT procedure

Communications Failure........................................................................................
............4
Transport Procedures ..........
....................................................................................... 4
Appropriate Facility............................................
.......................................................5
Control of EMS at the Scene ........................................................
6
Activation of Life Flight ............................................
....................................................... 7
Refusal of Treatment or Transport ......................................
...................................................... 9
Medical Legal .........................................
................................................................10
Communication Procedure....
12
Notification of Special Procedures ...
.. . 13
LCEMS Hospital By-pass
.
14
Cardiac Arrest Protocol

17
Ventricular Fibrillation

.19
PEA (Pulseless Electrical Activity)
........21
Asystole

..23

Trauma Cardiac Arrest

.24
Hypothermic Cardiac Arrest

.25
Bradycardia

..26
Third Degree Heart Block

28
Unstable Tachycardia

..29
Paroxysmal Supraventricular Tachycardia (PSVT)
.30
Ventricular Tachycardia

..31
Wide Complex Tachycardia of Uncertain Type
32
Cardiogenic Shock

33
Acute Coronary Syndrome

34
Acute Pulmonary Edema

35
Premature Ventricular Contractions (PVCs/VPBs)
.36
Automatic Implantable Cardiac Defibrillator (AICD)
.37

12-Lead ECG Protocols...

..38
Medication Infusion
Protocols
.41
CPR Protocol

47
Cessation of CPR

..49
DOA Policy

50
DNR Comfort Care Policy

52
Altered Mental States

..........57
Poisons and Overdose

..59
Seizures

..61
Syncope

..63
Asthma

65
Allergy/Anaphylaxis
.66

CVA

.68
Abdominal Pain

.70
Cyanide Poisoning

71
Hypertension

..72
Shock: (Medical)

..74
Vaginal
Bleeding
.75
Vomiting & Diarrhea

..76
COPD

77
Respiratory / Obstruction

..80
Asthma

82
Allergy/Anaphylaxis

83

Cardiac Arrest Protocol

85
Ventricular Fibrillation

.88
PEA (Pulseless Electrical Activity)
..89
Asystole

..90
Trauma Cardiac Arrest

.91
Hypothermic Cardiac
Arrest
..92
Bradycardia

..93
Symptomatic
Tachycardia
94
Deliveries and Neonatal Resuscitation
.95
APGAR scale / Inverted Pyramid
..97
Pediatric Tables

.98
Seizures

..99
Poisons and Overdose (Unconscious Unknown)
..100

General Trauma Protocol

104
Trauma Death ..
.108
Amputated Part

.109
Multi System Trauma Patient
.1
10
Load and Go Situations ..

114
Extremity Trauma
.
...115
Eye Injuries .
....116
Burns
..117
Drowning and Near Drowning .......................................
...120
Hypothermia and Frostbite..
..121
Hyperthermia

123
Haz
mat
.124
Selective C-spine .

.127

Rapid Sequence
Intubation
.131
Intubation
.133
Nasotracheal
Intubation
137
Needle
Decompression
..138
Cricothyrotomy
139
Nebulizer
..140
Pulse
Oximeter
.141
Intraosseous
Needle
.142
ShockPants
.143
Restraint
Policy
..144
Alternate IV
Access..................................
...................145
Auto Vent
2000
146
Laryngeal Mask Airway ......
148

CPAP (Continuous Positive Airway Pressure)

151
ResQPod.
..........................................................
.. 153
F.A.ST. 1.
..........................................................
...... 154
Use of Prescribed Albuterol Inhaler
.
157
Epinephrine Auto-Injector ...
.158
Blood Glucose Meter

.159
Administration of
Aspirin...............................................
.........160
Advanced EMTs IV
Starts
..161