EMS Protocol of the Week - Asthma/COPD/Wheezing (Adult and Pediatric)

I’ll be one of the first to admit that these protocols can be pretty densely packed with text, which is why I always support finding a way to simplify or consolidate protocols without sacrificing medical care. Previously, steps were taken to combine approaches to asthma and COPD into one document, and this year, it’s been taken a step further by having protocols for your wheezy adult and pediatric patients all in one place. You all know how to take care of your asthmatics/puffers/bloaters, but reading through this week’s protocol serves both as a good refresher and as a good example of the graduated responsibilities from CFR, to EMT, to paramedic, depending on who is on the scene.

Give it a skim – it’ll…take your breath away?

I think I might be starting to repeat some of these bits.

www.nycremsco.org or the protocol binder for more.

Dave

EMS Protocol of the Week - Abdominal Pain / Severe Nausea / Severe Vomiting (Adult and Pediatric)

Belly problems? Have we got a protocol for you! 

Not a ton to this week’s protocol – patients in severe abdominal pain will be kept NPO at all EMS provider levels, and paramedics can give a dose of ondansetron by Standing Order as needed – with a reminder to check an EKG, both for QT prolongation and for possible cardiac etiologies of the abdominal pain. Remember that there is a separate pain management protocol available for patients requiring prehospital analgesia.

That’s it for this week, hope you were all able to…stomach it?

www.nycremsco.org and the protocol binder for more

Dave

EMS Protocol of the Week - Heat Emergencies (Adult and Pediatric)

Believe it or not, the weather is actually nice in Brooklyn sometimes. We hopefully seem to finally be finding ourselves leaving behind all the lousy cold, wet, depressing weather, which means we’ve got approximately 1-2 weeks before we find ourselves in lousy hot, sticky, depressing weather! Which makes now the best time to start reviewing the prehospital approach to heat emergencies, which in NYC generally amounts to exposure control (remove outser clothing) and fluid resuscitation (for ALS). Unfortunately, there isn’t enough room in an ambulance for a full ice bath, but that leaves something for you to do when the patient arrives to the ED! Just remember not to drop the temperature too quickly and to avoid shivering.

Stay cool out there, gang! Or warm, depending on how the weather is today when this email goes out.

www.nycremsco.org and the protocol binder for more!

Dave