Cardiac / Resuscitation

Cardiac / Resuscitation Critical Care and Paramedic Levels

Chest Pain—ACS • Replaces “Chest Pain” protocol • More focused on cardiac chest pain • Early EKG • Cardiac equivalents • Shortness of breath, epigastric pain, nausea, altered mental status, weakness

STEMI • NEW PROTOCOL • Contact Medical Direction prior to transport • Destination decision • Possible helicopter transport • Chest Pain Checklist

Symptomatic Bradycardia • Changes: • Treatment based on symptoms only • Sedation option if pacing • Glucagon now in “Overdose” protocol

Tachycardia with a Pulse • Changes: • Treatment options more symptoms based • Still requires some interpretation of rhythm • Sedation option • Early EKG

Cardiac Arrest—Initial Care • NEW PROTOCOL • References rhythm based protocols • Reinforces BLS • Good CPR • Intubation not required if ventilation adequate • Consider supraglottic airway

VF/Pulseless VT • Changes: • Reinforces good CPR • Discourages transport unless ROSC • Field termination allowed and encouraged if unsuccessful after 20 minutes of ALS and poor EtCO2

PEA/Asystole • Changes: • Combines previous protocols • NO MORE Atropine • Again, discourages automatically transporting unless ROSC achieved

Post Cardiac Arrest • Changes: • More encompassing than just Therapeutic Hypothermia • ASA administration • EKG acquisition

Pediatric Cardiac Arrest • General Approach • Intubation is deemphasized • Understand Termination Rules

Pediatric Cardiac Arrest • Intubation Deemphasized • Epi, Epi, Epi!

Peds: Bradycardia • Epinephrine preferred over Atropine

Peds: Tachycardia

Neonatal Resuscitation

Cardiac / Resuscitation