Bonner County EMS System Patient Care Treatment Guidelines- Medical Emergencies & OB/GYN Neurologic Emergencies: Syncope -7002 SYNCOPE Prehospital Management of Syncope SUBJECTIVE Cardiac history, stroke, seizure Occult blood loss (GI, ectopic) Females: LMP, vaginal bleeding Fluid loss: nausea, vomiting, diarrhea Past medical history Medications OBJECTIVE Loss of consciousness with recovery Light headedness, dizziness Palpitations, slow or rapid pulse Pulse irregularity Decreased blood pressure ASSESSMENT Vasovagal Orthostatic hypotension Cardiac syncope Micturation / Defecation syncope Psychiatric Stroke Hypoglycemia Seizure Shock (see Shock Protocol) Toxicologic (Alcohol) Medication effect (hypotension) TREATMENT GUIDELINES R-EMR E – EMT A-AEMT P-PARAMEDIC **M-Medical Control ** ***Higher level of providers are responsible for lower level treatments*** Initial Patient Contact (2000). Administer Oxygen 10-15 L via non rebreather mask (9000). Consider Spinal Immobilization (9062). Perform Stroke Scale (A5). R Assist ALS with Cardiac Monitor and 12-lead EKG if indicated. Transport to receiving facility, with ALS intercept if ALS not already on-scene. E Blood Glucose Analysis (9040); for glucose <60 and awake with patent airway, administer 1 tube Oral Glucose PO/SL. 2 For glucose <60 and no IV access, administer 1 unit (1 mg) Glucagon IM. 2 Establish IV with NS, draw labs; do not delay transport for IV access. 2 Reevaluate blood glucose and treat if glucose remains <60 (7035) and patent IV, administer 12.5-25 gm of D50 (50% Dextrose) IV. Consider Naloxone for decreased respirations and glucose >60. Consider measuring orthostatic vital signs. A ________________________________________________________________________________________________________________ _______________________ BCEMS Medical Director Effective: 04/01/14 final 3/6/2022 page 1 of 2