Regarding medication dosing/defibrillation energy levels/medical protocols an adult is any patient whose height exceeds the length based tape system.

Transcription

1 Adult: Regarding burn and trauma routing an adult is 15 years old. Regarding medication dosing/defibrillation energy levels/medical protocols an adult is any patient whose height exceeds the length based tape system. APGAR SCORE: A system of scoring infant s physical condition one and five minutes after birth (appearance, pulse, grimace, activity and respiratory efforts). Approved Receiving Facilities: An approved receiving facility is a hospital/facility that may be utilized as a destination for transports originating in the pre-hospital emergency setting. AVPU Scale: A stands for alert and oriented to person, place, time and surroundings; V stands for verbal response to verbal stimuli; P stands for painful response to physical stimuli; U stands for unresponsive to verbal and painful stimuli Burn Criteria: Utilize the Adult and Pediatric Rule of 9 s to determine the percent of body surface area (BSA). Major burn criteria for adults and pediatrics are delineated in the respective trauma protocol. Electrical Therapy: This refers to cardioversion, defibrillation, or transcutaneous pacing. Glasgow Coma Scale: Process for measuring patient mental status in trauma patients. LOC: Level of consciousness of a patient typically noted by using the AVPU scale Medical Medallion or Bracelet: Any medallion or bracelet worn by a patient which has been inscribed to identify the patient and contains the letters DNR or the statement Do Not Resuscitate. Medical Control: The following individuals are approved to provide Online Medical Direction: Johnson County EMS System Medical Director Johnson County EMS System Deputy Medical Director Physician designated by EMS System Medical Director ED Physician or designee at a Base Hospital/Facility (refer to list of Base Hospitals/Facilities) Newly Born/Neonate: A person living the first few minutes after birth to 1 month old Johnson County Emergency Medical Services Protocols Page 150

2 Patient: Any person who has a medical complaint, a potential for illness or injury, or anyone for whom family and/or bystanders report a problem that is denied by the person Pediatric Patient: Regarding burn and trauma routing a pediatric patient is <15 years old. Regarding medication dosing/defibrillation energy levels/medical protocols a pediatric patient is any patient whose height DOES NOT exceed the length based tape system. Peri-arrest: The period either just before or just after a cardiac arrest when a patient s condition is very unstable Post partum: Defined as a period of 6 weeks after delivery PRN: A standard medical abbreviation for as needed Stable: Level of consciousness is appropriate and there are no significant signs of respiratory distress, hypoxia, or inadequate perfusion Unstable/Critical: Level of consciousness is inappropriate and there are significant signs of respiratory distress, hypoxia, or inadequate perfusion Unwitnessed Arrest: An arrest that was NOT seen or heard by a bystander or EMS provider Witnessed Arrest: An arrest that was seen or heard by a bystander or EMS provider Johnson County Emergency Medical Services Protocols Page 151

3 APGAR Score Chart Sign Heart Rate Absent <100 >100 Respiratory Effort Absent Slow, Irregular Good, Crying Muscle Tone Limp Some Extremity Movement Active Motion Reflex Irritability No Response Grimace Cough or Sneeze Color Blue, Pale Body Pink, Extremities Blue Completely Pink Approved Receiving Facilities/Capabilities Kansas Receiving Facilities Advent Health Shawnee Mission Hospital at Leawood 1 Missouri Receiving Facilities Centerpoint Advent Health Lenexa 1 Advent Health Overland Park 1 Children s Mercy Hospital - South Cushing (Leavenworth) KU 3 Lawrence Memorial Hospital at North Overland Park 1 Hospital at Roeland Park 1 Hospital at Shawnee 1 Hospital at South Olathe 1 Hospital at South Overland Park 1 Children s Mercy (Main) KCVA Lee s Summit Liberty North Kansas City Research (Belton) Leavenworth VA Research (KC) 3 Miami County (Paola) St. Joseph Menorah Olathe St. Luke s Lee s Summit St. Luke s Northland Johnson County Emergency Medical Services Protocols Page 152

4 Overland Park Regional St. Luke s Plaza 3 Overland Park Regional at Shawnee 1 Overland Park Regional at Olathe 1 Providence St. Mary s Truman Lakewood Truman Hospital Hill Rainbow Services, Inc. 2 St. John s (Leavenworth) St. Luke s South 1- Patients may be transported to these facilities if they have minor injury or minor illness and provider believes there is a low likelihood that patient will require secondary transport to a hospital. 2- Patients who have met the approved checklist criteria only 3- Comprehensive Stroke Center Johnson County Emergency Medical Services Protocols Page 153

5 Glasgow Coma Scale Eye Opening Spontaneous 4 To verbal stimuli 3 To painful stimuli 2 None 1 Verbal Response Conversational 5 Confused, disoriented 4 Inappropriate words 3 Incomprehensible words 2 None 1 Motor Response Obeys commands 6 Localizes pain 5 Withdraws from pain 4 Decorticate posturing 3 Decerebrate posturing 2 None 1 CPR Reference Chart CPR # of Type providers Adult CPR Compressions Per Min n/a At least 100 Continuous Compressions with ventilations interposed every 10th compression Pediatric 1 At least :2 pause for ventilation Pediatric 2 At least :2 pause for ventilation Neonate 2 At least 100 3:1 pause for ventilation Ratio Depth Metronome setting At least 2" no more than 2.5 1/3 AP Diameter 1/3 AP diameter 1/3 AP diameter minute compression cycles Change Compressors every 2 minutes Johnson County Emergency Medical Services Protocols Page 154

6 Pacing Reference Chart Neonate Pediatric Adult Pacing heart rate Milliamps start Milliamps increase to By 10 By 10 By 10 capture Upon capture Increase milliamps by 10% Increase milliamps by 10% Increase milliamps by 10% Sedation Use length based med dose Use length based med dose Midazolam: mg IV/IO/IM OR 10 mg Intranasal Johnson County Emergency Medical Services Page 155