Midstate Med Control Points

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thom.mccusker@gmail.com
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168611
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Midstate Med Control Points
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2012-09-03 22:33:27
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Midstate Med Control Points
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Midstate Med Control Points
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  1. Respiratory Distress, Med Control
    COPD
    • Possible Orders
    • Repeat neb
  2. Respiratory Distress, Med Control
    ASTHMA
    • Possible Orders
    • Epi 1:1000 0.01mg/kg (0.3mg max)
  3. Acute Pulmonary Edema, Med Control
    • 1. SBP<100 or if erectile dysfunction meds used w/in last 48hrs
    • 2. Possible Orders
    • Repeat Lasix/Bumix
    • Repeat MS 2-5mg SIVP
  4. Delivery Complications, Med Control
    Nuchal Cord
    Contact
  5. Delivery Complications, Med Control
    Prolapsed Cord
    Contact
  6. Delivery Complications, Med Control
    Breech Birth
    Establish
  7. Delivery Complications, Med Control
    Extremity Presentation
    Establish
  8. Delivery Complications, Med Control
    Postpartum Care of the Mother
    Establish
  9. Delivery Complications, Med Control
    Post Partum Care of the Infant
    • 1. Cyanotic
    • 2. CPR in progress "Neonatal Resuscitation"
  10. Delivery Complications, Med Control
    Neonatal Resusitation
    • Possible Orders
    • Repeat
    • 1. Epi
    • 2. Narcan
    • New Order
    • 1. D5 5-10 ml/kg over 20 min w/ possible other treatment options
  11. Routine Adult Cardiac Arrest, Med Control
    • Establish
    • Potential Orders:
    • 1. Additional IV line
    • 2. Additional Fluid Bolus
    • 3. Blood Sugar Check
  12. Pediatric Patient Assessment, Med Control
    Problem w/ Circulation
    Establish
  13. Pediatric Airway Algorithm, Med Control
    Post All Un-Maintainable Airways
    Establish
  14. Pediatric Patient Assessment, Med Control
    Routine Pediatric Cardiac Arrest - Post 4 Cycles
    Establish
  15. Pediatric Respiratory Distress, Med Control
    Last Protocol
    Establish
  16. Pediatric Asthma, Med Control
    • Establish
    • Pssible Physician Orders
    • 1. Establish IV NS admin bolus
    • 2. Repeat Neb
    • 3. Admin Epi (1:1,000) 0.01 mg/kg SQ Max 0.3mg
  17. Pediatric Suspected Croup or Epiglottitis, Med Control
    Respitory Arrest Post Ventilation Attempts
    Establish
  18. Pediatric Suspected Croup or Epiglottitis, Med Control
    Pre Epi Admin
    Establish to council if pt has complicated or cardiac hx before admin of Epi
  19. Pediatric Suspected Croup or Epiglottitis, Med Control
    Post Epi Admin
    • Establish
    • Possible Orders:
    • Nebulized Epi 5mg of 1:1000 in 3ml NS
  20. Pediatric Obstructed Airway, Med Control
    Complete Obstruction Last Protocol
    Establish
  21. Pediatric Pain Management, Med Control
    Pre Admin
    • Contact:
    • Admin 0.1mg/kg of MS up to 10mg slow IV 4-5min. If no IV access 0.1mg/kg MS IM or SC
  22. Pediatric Pain Management, Med Control
    Post 10min 1st Admin
    • Contact
    • pt still in pain >= 4/10 & SBP approp admin 0.05mg/kg MS up to 5mg slow IV 4-5min (total max dose of .15mg/kg up to 15mg)
  23. Pediatric Pain Management, Med Control
    Post Admin 1/1 or 2/2 final dose
    • Contact
    • Possible Physician Order
    • Additional MS
  24. Pediatric Alergic Reaction, Med Control
    • Establish
    • Possible Physician Order
    • Epi (1:1000) 0.01 mg/kg IM (2nd dose?)
  25. Pediatric Anaphylaxis, Med Control
    • Establish
    • Possible Physician Orders
    • 1. Repeat Epi IM or IV doses q 5
    • 2. Epi infusion 0.1 - 0.3 mcg/kg/min increasing to 1.0 mcg/kg/min as necessary
    • 3. Fluid Bolus 20 ml/kg of NS or LR
  26. Pediatric Fever, Med Control
    Final Protocol
    • Continued Reassessment
    • Contact
  27. Pediatric Altered Mental Status/Hypoglycemia/Coma, Med Control
    • Establish
    • Possible Physician Orders
    • 1. If no IV access establish IO
    • 2. Repeat D25
    • 3. Repeat Narcan
  28. Pediatric Seizures/Status Epilepticus, Med Control
    Seizure > 10 min
    • Establish
    • Possible Physician Orders:
    • 1. Repeat antiseizure meds (Ativan or Versed)
    • 2. Repeat D25
  29. Pediatric Seizures/Status Epilepticus, Med Control
    Seizure < 10 min
    • Establish
    • Possible Physician Orders
    • 1. Ativan 0.1 mg/kg (up to 2mg) SIVP or
    • 2. If unable to establish IV access admin Versed 0.1 mg/kg (up to 2 mg) IM
    • 3. Ativan/Versed may be repeated 1X
    • 4. Repeat D25 (0.5 gm/kg)
  30. Pediatric Overdose/Poisoning, Med Control
    Conscious Oral Ingestion
    • Establish
    • Possible Physician Orders
    • 1. Activated Charcoal
  31. Pediatric Overdose/Poisoning, Med Control
    General
    • Establish
    • Possible Physician Orders
    • 1. management specific for agent exposure
    • 2. additional D25 (.5gm/kg)
  32. Pediatric Overdose/Poisoning, Med Control
    Inhalation or Topical Exposure
    • Establish
    • Specific exposure info for further treatment orders & specific arrival instructions (eg specific hospital entrance)
  33. Pediatric Bradycardia, Med Control
    • Establish
    • Possible Physician Orders
    • 1. Pacing
    • 2. Other Modalities
  34. Pediatric Tachycardia, Med Control
    Establish
  35. Pediatric Overdose/Poisoning, Med Control
  36. Pediatric Pulseless Arrest, Med Control
    Establish Medical Control
  37. Pediatric Trauma Triage, Med Control
    • Establish
    • Help In Determining Appropriate Trauma Center
  38. Pediatric Burn Patient, Med Control
    Thermal Burns
    • Establish
    • Possible Physician Orders:
    • 1. Additional MS
    • 2. Intubation
  39. Pediatric Burn Patient, Med Control
    Chemical Burns
    • Establish
    • Possible Physician Orders
    • 1. MS IVP
  40. Pediatric Burn Patient, Med Control
    Electrical Burns
    Establish
  41. Hypothermia, Med Control
    Moderate
    • Contact
    • Possible Physician Prders:
    • 1. Dextrose 25 gms IVP
    • 2. Narcan 0.4 - 2.0 mg IVP
  42. Hypothermia, Med Control
    Severe
    Contact
  43. Near Drowning, Med Control
    Contact
  44. Universal Patient Care Guideline, Med Control
    Contact (if pt doesn't fit a guideline)
  45. Acute Coronary Syndromes, Med Control
    • Establish
    • Possible Physician Orders
    • 1. additional MS 2mg SIVP q 5 min (up to max of 0.1mg/kg) titrated to discomfort/pain relief probided SBP > 100
    • 2. additional sublingual Nitro SBP > 100
  46. Routine Adult Cardiac Arrest, Med Control
    • Establish
    • Possible Physician Orders
    • 1. additional IV lines
    • 2. additional fluid bolus
    • 3. additional shocks
    • 4. blood sugar check
  47. Tachycardias - Wide Complex Tachycardias, Med Control
    Stable
    • Possible Physician Orders
    • 1. Synchronized Cardioversion

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