1 2014 als protocol update dr. daniel j. olssonsusie surprenant cnyems regional medical director...
Post on 21-Jan-2016
214 Views
Preview:
TRANSCRIPT
11
2014 ALS PROTOCOL
UPDATE
Dr. Daniel J. Olsson Susie Surprenant
CNYEMS Regional Medical
Director
CNYEMS Executive Director
22
OverviewOverview CNYEMS-Midstate-North Country CNYEMS-Midstate-North Country
Collaborative ALS Protocol Update. Collaborative ALS Protocol Update.
Thirteen of the ALS protocols have been Thirteen of the ALS protocols have been updated to accommodate the new updated to accommodate the new Advanced EMT level. Advanced EMT level.
The following slides contain highlighted The following slides contain highlighted sections where the protocols changes sections where the protocols changes and/or additions have occurred.and/or additions have occurred.
Adult Blood Glucose (hypoglycemia) Adult Blood Glucose (hypoglycemia) changed to < 60 mg/dL.changed to < 60 mg/dL.
Adult Naloxone dose changed toAdult Naloxone dose changed to 0.4 mg IV; IM or IN. 0.4 mg IV; IM or IN.
““Secondary advanced airway device “ Secondary advanced airway device “ verbiage changed to “alternative rescue verbiage changed to “alternative rescue airway device”airway device”..
Acute Coronary SyndromeAcute Coronary Syndrome
New Medications for AEMT:New Medications for AEMT:– AspirinAspirin– Nitroglycerin PasteNitroglycerin Paste– Nitroglycerin SprayNitroglycerin Spray– Nitroglycerin TabletNitroglycerin Tablet
33
44
Acute Respiratory Distress Acute Respiratory Distress Asthma or COPDAsthma or COPD
New Medications for AEMT:New Medications for AEMT:– Albuterol SulfateAlbuterol Sulfate
New Skill:New Skill:– CPAPCPAP
55
66
Airway ManagementAirway Management
Adult “secondary advanced airway Adult “secondary advanced airway device “ verbiage changed to device “ verbiage changed to “alternative rescue airway device”“alternative rescue airway device”..
Intermediates and AEMTs are only able Intermediates and AEMTs are only able to utilize alternative rescue airway to utilize alternative rescue airway devices for patients in respiratory or devices for patients in respiratory or cardiac arrest. cardiac arrest.
Examples of alternative rescue airway Examples of alternative rescue airway devices:devices:
– CombitubeCombitube– King AirwayKing Airway– LMALMA
77
88
Allergic Reaction / Allergic Reaction / AnaphylaxisAnaphylaxis
New Medications for AEMT:New Medications for AEMT:– Albuterol SulfateAlbuterol Sulfate– Epinephrine 1:1,000Epinephrine 1:1,000
99
1010
Alerted Mental StatusAlerted Mental Status
Adult Blood Glucose (hypoglycemia) Adult Blood Glucose (hypoglycemia) changed to < 60 mg/dL.changed to < 60 mg/dL.
Adult Naloxone dose changed toAdult Naloxone dose changed to 0.4 mg IV; IM or IN. 0.4 mg IV; IM or IN.
New Medications for AEMT:New Medications for AEMT:– Dextrose 50%Dextrose 50%– GlucagonGlucagon– NaloxoneNaloxone
1111
1212
Asystole and Pulseless Asystole and Pulseless Electrical Activity (PEA)Electrical Activity (PEA)
New Medications for AEMT:New Medications for AEMT:– Epinephrine 1:10,000Epinephrine 1:10,000
1313
1414
Poisoning / OverdosePoisoning / Overdose
Adult Naloxone dose changed toAdult Naloxone dose changed to 0.4 mg IV; IM or IN. 0.4 mg IV; IM or IN.
New Medications for AEMT:New Medications for AEMT:– NaloxoneNaloxone
1515
1616
Pulmonary EdemaPulmonary Edema
New Medications for AEMT:New Medications for AEMT:– Nitroglycerin PasteNitroglycerin Paste– Nitroglycerin SprayNitroglycerin Spray– Nitroglycerin TabletNitroglycerin Tablet
New Skill:New Skill:– CPAPCPAP
1717
1818
SeizuresSeizures
Adult Blood Glucose (hypoglycemia) Adult Blood Glucose (hypoglycemia) changed to < 60 mg/dL changed to < 60 mg/dL
New Medications for AEMT:New Medications for AEMT:– Dextrose 50%Dextrose 50%– GlucagonGlucagon
1919
2020
V-Fib / Pulseless V-TachV-Fib / Pulseless V-Tach
New Medications for AEMT:New Medications for AEMT:– Epinephrine 1:10,000Epinephrine 1:10,000
2121
2222
Airway Management - Airway Management - PediatricPediatric
““Secondary advanced airway device“ Secondary advanced airway device“ verbiage changed to “alternative verbiage changed to “alternative rescue airway device”rescue airway device”..
Patients 16 years and older.Patients 16 years and older.
Intermediates and AEMTs are only Intermediates and AEMTs are only able to utilize alternative rescue able to utilize alternative rescue airway devices for patients in airway devices for patients in respiratory or cardiac arrest. respiratory or cardiac arrest.
2323
2424
Fluid Challenge - PediatricFluid Challenge - Pediatric
Fluid Administration:Fluid Administration:– Normal Saline bolusNormal Saline bolus
2525
2626
IV / IO Therapy - PediatricIV / IO Therapy - Pediatric
New Skill for AEMT:New Skill for AEMT:– Patients 6 years and older: Patients 6 years and older:
IV or IO accessIV or IO access– Patients < 6 years in cardiac arrest: Patients < 6 years in cardiac arrest:
IV or IO accessIV or IO access
2727
2828
Review of Protocol Review of Protocol ChangesChanges
Adult Blood Glucose (hypoglycemia) Adult Blood Glucose (hypoglycemia)
changed to < 60 mg/dL.changed to < 60 mg/dL.
Adult Naloxone dose changed to Adult Naloxone dose changed to
0.4 mg IV; IM or IN. 0.4 mg IV; IM or IN.
““Secondary advanced airway device Secondary advanced airway device “ verbiage changed to “alternative “ verbiage changed to “alternative rescue airway device”.rescue airway device”.
2929
3030
New Medications for New Medications for AEMT LevelAEMT Level
AspirinAspirin Albuterol SulfateAlbuterol Sulfate Dextrose 50%Dextrose 50% Epinephrine 1:1,000Epinephrine 1:1,000 Epinephrine 1:10,000Epinephrine 1:10,000 GlucagonGlucagon NaloxoneNaloxone Nitroglycerin PasteNitroglycerin Paste Nitroglycerin SprayNitroglycerin Spray Nitroglycerin TabletNitroglycerin Tablet
Fluid AdministrationFluid Administration Normal Saline bolus Normal Saline bolus
3131
New Skills for AEMT LevelNew Skills for AEMT Level
Alternative Rescue Airway DeviceAlternative Rescue Airway Device–Patients 16 years and olderPatients 16 years and older
CPAP – AdultCPAP – Adult
Patients 6 years and older: Patients 6 years and older: – IV or IO accessIV or IO access
Patients < 6 years in cardiac arrest: Patients < 6 years in cardiac arrest:
– IV or IO accessIV or IO access
3232
Next StepsNext Steps AEMT providers will complete an on-AEMT providers will complete an on-
line 2014 AEMT Protocol Test. line 2014 AEMT Protocol Test.
In order to continue to practice in the In order to continue to practice in the Region, an AEMT provider will need to Region, an AEMT provider will need to complete the ALS Protocol Update and complete the ALS Protocol Update and pass the on-line Protocol Test.pass the on-line Protocol Test.
The updated ALS Protocols will go The updated ALS Protocols will go into effective December 8, 2014. into effective December 8, 2014.
All currently certified Intermediates must All currently certified Intermediates must be certified under the newbe certified under the new
AEMT Standards by June 30, 2015. AEMT Standards by June 30, 2015.
All Intermediate Protocols will end on All Intermediate Protocols will end on June 30, 2015.June 30, 2015.
top related