Primary Care Paramedic Cardiac Arrest Directives (Ontario 2011)

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Anonymous
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197702
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Primary Care Paramedic Cardiac Arrest Directives (Ontario 2011)
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2013-02-03 20:05:57
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Primary Care Paramedic Cardiac Arrest Directives
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Primary Care Paramedic Arrest Directives from the ALS (Ontario 2011)
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  1. Normotension in Adults
    SBP > 100 mmHg
  2. Hypotension in Adults
    SBP < 90 mmHg
  3. Bradycardia in Adults
    < 50 BPM
  4. Tachycardia in Adults
    > 100 BPM
  5. Tachypnea in Adults
    RR > 28 breath/min
  6. Vitals in pediatrics with age 0 - 6 months
    • Respiratory Rate: 30 - 60
    • Heart Rate: 80 - 180
  7. Vitals in Pediatrics with age 6 months - 3 years
    • Respiratory Rate: 20 - 45
    • Heart Rate: 75 - 140
  8. Vitals in Pediatrics age 6
    • Respiratory Rate: 16 - 24
    • Heart Rate: 70 - 110
  9. Equation to calculate weight of pediatrics
    Weight (kg) = (age x 2) + 10
  10. Equation to calculate Blood pressure in children between ages 1 and 10
    Systolic Blood pressure = 70 + (2 x age)
  11. Hypoglycemia in people age > 2 years
    Blood glucometry < 4.0 mmol/L
  12. Hypoglycemia in people age < 2 years
    Blood glucometry < 3.0 mmol/L
  13. Minimum Age for AED Defibrillation
    > 30 days
  14. Conditions for Medical TOR in a Medical Cardiac Arrest
    • Age > 18 years
    • Arrest not witnessed by EMS and no ROSC and no shocks delivered
  15. Intervals for CPR
    2 minute intervals
  16. Contraindications for CPR
    • Obviously dead
    • Meet conditions of DNR standard
  17. Max number of shocks delivered in Medical Cardiac Arrest
    4
  18. Dose during manual defibrillation
    • First Dose: 2 J/kg
    • Subsequent Doses: 4 J/kg
  19. When to patch in Medical Cardiac Arrest
    Patch to BHP after 3rd analysis to consider Medical TOR
  20. What do you do in unusual circumstances (pediatric patients or toxicological overdoses) in a medical cardiac arrest
    Consider starting transport after first rhythm analysis
  21. Indications in trauma cardiac arrest
    Cardiac arrest secondary to severe blunt or penetrating trauma
  22. Conditions for Trauma TOR
    • Age: > 16 years
    • No defibrillation delivered
    • Monitored HR = 0 OR
    • Monitored HR > 0 and closest ER > 30 min transport time away
  23. Max number of shocks in trauma cardiac arrest
    1 shock
  24. Mandatory Patch point in Trauma Cardiac Arrest
    Patch to BHP to apply Trauma TOR
  25. How many shocks in Hypothermia Cardiac Arrest
    • 1 shock
    • transport to nearest facility after first analysis
  26. Number of shocks in Foreign body airway obstruction cardiac arrest
    • 1 shock
    • if obstruction is removed initiate management as a medical cardiac arrest (3 more shocks)
    • If obstruction cant be removed transport to nearest facility after first analysis
  27. Age criteria for the neonatal resuscitation medical Directive
    newborn or <30 days of age
  28. Initial care in neonatal resuscitation
    • Provide warmth
    • Position/clear airway (as necessary)
    • Dry, stimulate, reposition
  29. Intervals between stages in neonatal resuscitation
    30 seconds
  30. Step after evaluate respirations heart rate and colour in neonatal resuscitation
    • Apnea, gasping or HR < 100 = provide positive pressure ventilation with BVM using room air
    • Breathing and HR > 100 + pink = supportive care
  31. Step after provided BVM ventilations in neonatal resuscitation
    • HR > 100 + pink = supportive care
    • HR < 60 = ventilate using 100% oxygen, administer chest compression
  32. What do you do if HR comes back above 60 in the neonatal resuscitation after providing chest compressions and ventilation with 100% oxygen
    Stop compressions, ventilate using room air

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