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Chest Pain
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including allergies and ED medications.
- Administer 324 mg ASA orally
- 12 lead EKG
- IV access
- Reconfirm allergies and ED medications
- Administer 0.4 mg NTG SL
- Prepare for transport
- Reassess including vitals and EKG
- Consider 4.0 mg Zofran for nausea
- Consider 2.0 - 10.0 mg Morphine or 25 - 100 mcg Fentanyl for pain and reduced cardiac workload.
- Reassess every 5 minutes, 12 lead EKG, re-administer 0.4 mg NTG SL every 3 - 5 minutes as needed.
- Transport to PCI center
-
Stroke
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including allergies.
- 12 lead EKG
- IV access
- Stroke scale:
- facial droop
- arm drift
- grips
- speech
- Time of onset of symptoms
- BGL
- Activate stroke alert and transport to a stroke center with CT Scan
- Position patient and protect paralyzed extremities.
- Reassess every 5 minutes for changes in condition, support ABCs, protect airway.
-
Hypoglycemia
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including allergies.
- IV access
- BGL
- Administer 25g Dextrose (D50) IV
- Reassess every 5 minutes
- Transport while maintaining airway
- Consider second dose of D50 if needed
-
Seizure
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including allergies.
- Consider c-spine precautions
- IV access
- Protect patient from harming self if still seizing
- 0.5 - 2.0 mg Ativan/Diazepam IV or 1.0 - 4.0 mg IM if IV access unavailable
-
CHF
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including L/S, SpO2, and ETCO2.
- 12 lead EKG
- IV access
- 0.5 - 1.0 inch NTG paste
- CPAP
- Assess for JVD, peripheral edema
- Consider 4.0 mg Zofran for nausea
- Reassess frequently including L/S, quality of breathing, ETCO2, SpO2, and 12 lead EKG
-
COPD
- BSI / Scene Safety
- Assess ABCs
- O2 prn
- Attach monitor and obtain baseline vitals while obtaining SAMPLE hx including allergies.
- IV access
- 12 lead EKG
- 2.5 mL Albuterol mixed with 2 - 3 mL NS via SVN
- Consider adding 0.5 mL Ipratropium to SVN for duo-neb
- Transport in fowler or semi-fowler position
- Reassess every 5 minutes for changes in condition, work of breathing, coloring, SpO2, ETCO2, 12 lead EKG
- Have suction ready and be prepared to manage airway more aggressively if needed.
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