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Vermont Statewide EMS Protocol Summary

Vermont Statewide EMS Protocol Summary. Objectives. Review new Vermont Statewide EMS Protocols What happens out there On-line Medical Direction Changes to your practice. Vermont is now a National Scope of Practice State. New Vermont Statewide EMS Protocols. Stroke Systems

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Vermont Statewide EMS Protocol Summary

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  1. Vermont Statewide EMS Protocol Summary

  2. Objectives • Review new Vermont Statewide EMS Protocols • What happens out there • On-line Medical Direction • Changes to your practice

  3. Vermont is now a National Scope of Practice State

  4. New Vermont Statewide EMS Protocols • Stroke Systems • Trauma Triage and Destination • STEMI Systems • Burn Care • Sepsis Alert • Termination of Resuscitation • Epinephrine by AEMT • IO access by AEMT • Naloxone by EMT • CPAP by AEMT • Advanced Spinal Assessment

  5. Critical Action Question: Last time without symptoms

  6. Cincinnati Stroke Scale

  7. Establish Stroke Alert Criteria

  8. Establish Stroke Alert Criteria • Rapid transport to correct facility based on regional transport agreements • On scene time < 10 minutes • Rapid CT head, Neurology consult, ? tPA

  9. Trauma Triage and Transport Decision

  10. Field Triage of Injured Patients Published: January 2012 Available for FREE at: www.cdc.gov/Fieldtriage

  11. Physiologic Criteria Anatomic Criteria Mechanism of Injury Criteria Special Considerations

  12. Step 1: Physiologic Criteria

  13. Step 2: Anatomic Criteria

  14. Step 3: Mechanism of Injury Criteria

  15. Step 4: Special Considerations

  16. Destination Determination • Criteria • Distance

  17. Physiologic & Anatomic Criteria

  18. STEMI SYSTEMS

  19. EMTs can now obtain and transmit ECG

  20. STEMI System • En-route: • Obtain 12 Lead ECG FIRST • If automated read is “ACUTE MI,” call to activate STEMI. Transmit ECG en-route as soon as possible. • Aspirin • IV Access • Nitroglycerin • Expedited Transfer to appropriate facility

  21. Burn Updates

  22. Fluid Administration in Burns - Adults

  23. Adult Burn Fluid Guidelines

  24. Pediatric Burn Fluid Guidelines

  25. SEPSIS ALERT!

  26. Termination of Resuscitation

  27. Validation of a Rule for Termination ofResuscitation in Out-of-Hospital Cardiac Arrest • 1240 patients • Rule recommended termination for 776 patients • Of these, only 4 (0.5%) survived. • Positive predictive value for death of 99.5%. • Decrease rate of transportation from 100% to 37.4%

  28. Epinephrine by AEMT

  29. Naloxone by EMT Administer Naloxone 2.0 mg Nasal via atomizer (1.0mg per nostril)

  30. CPAP Indications

  31. CPAP Contraindications

  32. CPAP with CHF

  33. Advanced Spinal Assessment Protocol

  34. Positive MOI

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