1. Cardiac / Resuscitation Critical Care and Paramedic Levels

2. 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

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

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

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

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

7. 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

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

9. Post Cardiac Arrest Changes: – More encompassing than just Therapeutic Hypothermia ASA administration EKG acquisition

10. Pediatric Cardiac Arrest General Approach Intubation is deemphasized Understand Termination Rules

11. Pediatric Cardiac Arrest Intubation Deemphasized Epi, Epi, Epi!

12. Peds: Bradycardia Epinephrine preferred over Atropine

13. Peds: Tachycardia

14. Neonatal Resuscitation