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Intermediate Protocol Review. Intermediate Level. Cardiac Arrest—Initial Care. NEW PROTOCOL References rhythm based protocols Reinforces BLS Good CPR Intubation not required if ventilation adequate Consider supraglottic airway. Post Cardiac Arrest.
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Intermediate Protocol Review Intermediate Level
Cardiac Arrest—Initial Care • NEW PROTOCOL • References rhythm based protocols • Reinforces BLS • Good CPR • Intubation not required if ventilation adequate • Consider supraglottic airway
Post Cardiac Arrest • Therapeutic Hypothermia interventions for all levels of care.
Pediatric Cardiac Arrest • General Approach • Intubation is deemphasized • Understand Termination Rules
Trauma: Aeromedical Utilization • Must SIGNIFICANTLY reduce transport time • Signs of life!!! • Don’t wait for the helicopter • <20 mile transport? • Entrapment
Trauma: Pregnant Patients • Adult trauma pt > 20 weeks gestation • Not meeting trauma criteria – ER of their choice • Meeting trauma criteria – Adult trauma center!
Trauma: Chest • Bilateral needle decompression as standing order for Trauma Code with suspected chest injury.
Trauma: Hypoperfusion • Differing fluid goals for compressible injury • Reflects current ITLS/ATLS guidelines
Airway Management • Changes: • CPAP for EMT-I • Must be credentialed • Earlier use of supraglottic airways • Waveform required for intubated patients • Recommended for alternate airways
Continuous Positive Airway Pressure • Changes • EMT-I allowed* • *If credentialed • Remember indications and contraindications
Diabetic Emergencies • NEW PROTOCOL • Addresses low and high blood sugar • Intermediates use D10 for hypoglycemia
Pain / Nausea /Sedation • A fluid bolus makes almost anyone feel better