Paramedic AssistParamedic Assist
Presented by Shore Emergency Educators
Presented by Shore Emergency Educators
ObjectivesObjectives
Overview of BLS protocols
BLS►ALS Assistance
Overview of BLS protocols
BLS►ALS Assistance
BLS ProtocolsBLS Protocols
Soon to be updated!!! Yeah!!!!!!!Soon to be updated!!! Yeah!!!!!!!
ProtocolsProtocols
General patient careChest painAcute respiratory distressSevere allergic reactionDiabetics with altered mental statusAutomatic external defibrillatorPediatric and adult traumaPulse OximetryRefusal of serviceGuidelines regarding DNR orders
General patient careChest painAcute respiratory distressSevere allergic reactionDiabetics with altered mental statusAutomatic external defibrillatorPediatric and adult traumaPulse OximetryRefusal of serviceGuidelines regarding DNR orders
General Patient CareGeneral Patient Care
Safety: scene, universal precautions
ABC’s
SAMPLE History
Pertinent physical exam
Oxygen as appropriate
Appropriate transportation
Transfer of care
Safety: scene, universal precautions
ABC’s
SAMPLE History
Pertinent physical exam
Oxygen as appropriate
Appropriate transportation
Transfer of care
Chest PainChest Pain
Non-traumatic
Possible cardiac origin
Follow General Patient Care Protocol
Nitroglycerin Standing Order
Non-traumatic
Possible cardiac origin
Follow General Patient Care Protocol
Nitroglycerin Standing Order
Assist patient with prescribed nitroglycerinAssure BP > 100 systolic prior to each dose!!!Maximum 3 doses3 to 5 minutes apartRecheck blood pressure between doses
VIAGRA or other ED Drugs
Acute Respiratory DistressAcute Respiratory Distress
Signs and Symptoms of acute exacerbations of asthma, emphysema, reactive airway disease, and allergic reactions include:
Cough, shortness of breath and air hunger, wheezing, diminished breath sounds, retractions, and tachypnea.
Signs and Symptoms of acute exacerbations of asthma, emphysema, reactive airway disease, and allergic reactions include:
Cough, shortness of breath and air hunger, wheezing, diminished breath sounds, retractions, and tachypnea.
Acute Respiratory DistressAcute Respiratory Distress
Assist/Administer MDIShort acting
Rescue inhaler
Albuterol, Atrovent, Proventil, Combivent
Assist/Administer MDIShort acting
Rescue inhaler
Albuterol, Atrovent, Proventil, Combivent
Acute Respiratory DistressAcute Respiratory Distress
CPAP—Pilot program
ALS Standard
Different Equipment
Need to perform accurate assessment quickly
CPAP—Pilot program
ALS Standard
Different Equipment
Need to perform accurate assessment quickly
CPAPCPAP
Severe Allergic ReactionSevere Allergic Reaction
Urticaria (hives) with respiratory distress.
Partial or complete airway obstruction
(sensation of throat closing)
Hypotension or evidence of shock.
Urticaria (hives) alone with a history of life threatening allergic reaction
Patients with severe asthma may manifest their allergic reaction primarily as an asthma attack.
Urticaria (hives) with respiratory distress.
Partial or complete airway obstruction
(sensation of throat closing)
Hypotension or evidence of shock.
Urticaria (hives) alone with a history of life threatening allergic reaction
Patients with severe asthma may manifest their allergic reaction primarily as an asthma attack.
Diabetics with Altered Mental StatusDiabetics with Altered Mental Status
Patient should be a known diabetic suffering from an altered mental status.
The cause of the altered mental status could be low blood sugar.
Follow general patient care protocol.
Patient should be a known diabetic suffering from an altered mental status.
The cause of the altered mental status could be low blood sugar.
Follow general patient care protocol.
Diabetics with Altered Mental StatusDiabetics with Altered Mental Status
Be alert for signs of trauma during the physical examination. Patients with altered mental status due to trauma should not be given anything by mouth in case their condition worsens unexpectedly or they require an operation to repair damage.
Be alert for signs of trauma during the physical examination. Patients with altered mental status due to trauma should not be given anything by mouth in case their condition worsens unexpectedly or they require an operation to repair damage.
ALS ProtocolsALS Protocols
All patient care starts the same no matter ALS or BLS.
Patient Assessment
The better BLS assesses the patient if on scene first, the quicker the patient receives care, which is the ultimate goal
All patient care starts the same no matter ALS or BLS.
Patient Assessment
The better BLS assesses the patient if on scene first, the quicker the patient receives care, which is the ultimate goal
Overview of ALS EquipmentOverview of ALS Equipment
You are not responsible to know how to operate ALS equipment, but general knowledge is helpful.
12 Lead EKG Monitor
Never should you administer/assist in any medication that is outside of your scope of practice (protocols).
You are not responsible to know how to operate ALS equipment, but general knowledge is helpful.
12 Lead EKG Monitor
Never should you administer/assist in any medication that is outside of your scope of practice (protocols).
ECG MonitorECG Monitor
ON/OFF
ECG MonitorECG Monitor
12 Lead Button
ECG MonitorECG Monitor
Selector Wheel
ECG MonitorECG Monitor
PRINTERDEFIB CABLES
ECG MonitorECG Monitor
LEAD AND SIZE
NIBP
ECG MonitorECG Monitor
SA02/EtCO2
12 Lead12 Lead
V1-V2- 4TH
V3
V4-5th
V5
V6-6th
V1-V2- 4TH
V3
V4-5th
V5
V6-6th
12 Lead12 Lead
12 Lead12 Lead
12 Lead12 Lead
CPR DevicesCPR Devices
Keep providers seated
Don’t “tire” out
Consistent
Keep providers seated
Don’t “tire” out
Consistent
CPR DevicesCPR Devices
CPR DeviceCPR Device
IV TubingIV Tubing
Trauma TubingTrauma Tubing
Trauma Tubing (cont.)Trauma Tubing (cont.)
HypothermiaHypothermia
Resuscitated Cardiac Arrest
Ice Packs
Cold Fluid
Resuscitated Cardiac Arrest
Ice Packs
Cold Fluid
HypothermiaHypothermia
HypothermiaHypothermia
That’s allThat’s all