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