Emergency medical services pre-hospital treatment protocols : complete text

628 Pages·2000·21.2 MB·English

by  Massachusetts. Office of Emergency Medical Services

EMERGENCY MEDICAL SERVICES
PRE-HOSPITAL TREATMENT PROTOCOLS
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
OFFICE OF EMERGENCY MEDICAL SERVICES
56 Roland Street, Suite 100
BOSTON, MA 02129
[phone]
www.state.ma.us/dph/oems
DATE DUE
MASS KFM 2763 .E43 M374 200
Massachusetts. Office of
Emergency Medical Services.
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DATE DUE
BORROWER'S NAME
llASSnCFM 2763 .E43 H374 200
Massachusetts. Office of
Emergency Medical Services.
Emergency medical services
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7 DAYS ONLY
IT CANNOT BE RENEWED OR TRANSFERRED
COMMONWEALTH OF MASSACHUSETTS
HAMPSHIRE LAW LIBRARY
COURTHORSE- 99 MAIN STREET
NORTHAMPTON, MASS. 01060
DEMCO
TABLE OF CONTENTS
ACKNOWLEDGMENTS
INTRODUCTION & GENERAL POLICIES
PROTOCOLS
1. CARDIAC EMERGENCIES
1.1 Asystole (Cardiac Arrest)
1.2 Atrial Fibrillation
1.3 Atrial Flutter
1 .4 Bradydysrhythmias
1.5 Chest Pain
1 .6 Post-Resuscitation Care
1 .7 Premature Ventricular Contractions
1 .8 Pulseless Electrical Activity (Cardiac Arrest)
1 .9 Supraventricular Tachycardia
1.10 Ventricular Fibrillation / P ulseless Ventricular Tachycardia (Cardiac Arrest)
1.11 Ventricular Tachycardia with Pulses
2. ENVIRONMENTAL EMERGENCIES
2.1 Drowning and Near-Drowning Emergencies
2.2 Electrocution / L ightning Injuries
2.3 Hyperthermia / H eat Emergencies
2.4 Hypothermia / C old Emergencies
2.5 Radiation Injuries
3. MEDICAL EMERGENCIES
3.1 Abdominal Pain
3.2 Allergic Reactions / A naphylaxis
3.3 Altered Mental Status / D iabetic
3.4 Bronchospasm / R espiratory Distress
3.5 Congestive Heart Failure / P ulmonary Edema
3.6 Eye Emergencies
3.7 Hypertensive Emergencies
3.8 Obstetrical Emergencies
3.9 Seizures
3.10 Shock (Hypoperfusion) of Unknown Etiology
3.1 1 Syncope of Unknown Etiology
3. 1 2 Toxicology / P oisoning / S ubstance Abuse / O verdose
Third Edition 11/1/00
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PROTOCOLS
4. TRAUMA EMERGENCIES
4.1 Abdominal / P elvic Trauma
4.2 Bums / I nhalation Injuries
4.3 Head Trauma / I njury
4.4 Musculoskeletal Injuries
4.5 Multi-System Trauma
4.6 Soft Tissue / C rush Injuries
4.7 Spinal Column / C ord Injuries
4.8 Thoracic Trauma
4.9 Traumatic Cardiopulmonary Arrest
4. 1 0 Traumatic Amputations
5. PEDIATRIC EMERGENCIES
5.1 Newborn Resuscitation
5.2 Pediatric Anaphylaxis
5.3 Pediatric Bradydysrhythmias
5.4 Pediatric Bronchospasm / R espiratory Distress
5.5 Pediatric Cardiopulmonary Arrest
5.6 Pediatric Coma / A ltered Mental Status
5.7 Pediatric Seizures
5.8 Pediatric Shock
5.9 Pediatric Supraventricular Tachycardia
5.10 Pediatric Trauma & Traumatic Arrest
5.1 1 Pediatric Upper Airway Obstruction
5. 1 2 Pediatric Ventricular Fibrillation / P ulseless Ventricular Tachycardia
Third Edition 11/1/00

APPENDICES
A MEDICATIONS LIST
B COMFORT CARE/DNR PROTOCOL
C APGAR SCORE
D OPTIONAL SKILLS / P ROCEDURES
AED
Needle Chest Decompression
Needle Cricothyroidotomy
Intraosseous Infusion
NGT/OGT by paramedics in post-intubation patients
E ENDOTRACHEAL TUBE SIZES
F BURN CHART - P EDIATRIC & ADULT
G TRAUMA SCORES
H SPECIAL SKILL: Medication Assisted Intubation (MAI) by paramedics
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J AIR AMBULANCE TRAUMA TRIAGE GUIDELINES
K PROCESS FOR PROPOSING CHANGES TO TREATMENT PROTOCOLS
AND INTRODUCTION OF NEW CONCEPT IMPLEMENTATION
L MASS CASUALTY INCIDENTS / T RIAGE
M PEDIATRIC VITAL SIGNS CHART
N INTERFACILITY TRANSFER GUIDELINES
BIBLIOGRAPHY
Third Edition 11/1/00
Digitized by tine Internet Arcliive
in 2015
https://archive.org/details/emergencynnedicalOOmass
ACKNOWLEDGMENTS
The Massachusetts Department of Public Health, Office of Emergency Medical Services
gratefully acknowledges the efforts of many individuals and organizations in the development of
this text. The most prominent contributions of time and effort have come from the five Regional
Councils in the Commonwealth and their respective Medical Directors and Executive Directors.
Many thanks to all of you and to those EMS physicians, Basic EMTs, Intermediate EMTs, and
Paramedics around the Commonwealth who have greatly influenced the development process
and the resultant Protocols Text.
Louise Goyette John C. Benanti, M.D., FACEP
Director Medical Director
Special Recognition:
Bruce Auerbach, M.D., FACEP
Elliott Cohen, M.D., FACEP
Robert Korn, M.D., FACEP
Ray Conway, M.D., FACEP
Gary Setnick, M.D., FACEP
Tim LeBlanc, NREMT-P
Paul Klainer, M.D., FACEP
Kenneth Williams, M.D., FACEP
Third Edition 11/1/00
ACKNOWLEDGMENTS Second Edition Page v