EMS Operations Manager

Total Page:16

File Type:pdf, Size:1020Kb

EMS Operations Manager Guideline Name: Department: Basic Life Support Orange County Ambulance and Emergency Services Response Effective Date: Issued: Approval(s): Kim Woodward October 1, 2018 October 1, 2018 EMS Operations Manager SCOPE This procedure applies to all members of the Emergency Medical Services (EMS) Division and all prehospital providers franchised to provide BLS 911 services with Orange County Emergency Services. PURPOSE To set forth policy and procedure for the proper dispatch, service coverage, safe and consistent operations, and quality assurance of 9-1-1 use of basic life support ambulances within the service area of Orange County. DEFINITIONS Basic Life Support (BLS) is transportation by a ground ambulance vehicle and the provision of medically necessary supplies and services, including BLS ambulance services as defined by the State Office of Emergency Medical Services (OEMS). The ambulance shall be staffed by an individual who is credentialed in accordance with 10A NCAC 13P .0502 and G.S. 131E-159 as an Emergency Medical Technician (EMT).1 Basic Life Support (BLS) Units in Orange County working under the 9-1-1 Service Contract will consist of two North Carolina certified Emergency Medical Technicians who also must be credentialed to practice independently by Medical Direction. There shall be no more than three medical providers dispatched to a 9-1-1 call per ambulance. DISPATCH Unit Designations – BLS Unit Designations will be defines by Orange County Emergency Services’ Emergency Communications Division. The BLS unit with be named “BLS” plus the number of the assigned district of coverage. BLS units may be collocated with an Advanced Life Support unit or in a district in place of a Advanced Life Support unit. For example, if BLS 1 is assigned in District 1, their response district will be “BLSN” BLS Unit Designated May Substitute or Enhance 20-Minute Dispatch Area BLS 1 Medic 1 BLSN BLS 2 Medic 2 BLSS BLS 3 Medic 3 BLSS 1 Orange County Emergency Services Basic Life Support Ambulance and Response October 1, 2018 BLS 4 Medic 4 BLSN BLS 5 Medic 5 BLSN BLS 6 Medic 6 BLSS BLS 7 Medic 7 BLSN BLS 8 Medic 8 BLSS BLS 9 Medic 9 BLSS Geo-Fencing - The CAD system will only recommend BLSS and/or BLSN if the geo-fencing based on AVL is within 20-minutes of the call within either the North side or South side. Any distance greater than 20-minutes will be dispatched to the closest ambulance resource regardless of call type or level of service. Call Types are medical priority codes as part of Medical Priority Dispatch System used to determine appropriate resources. Medical Direction in cooperation with EMS Administration and the Communications Division approved the following call type determinants for dispatch of BLS units. Dispatch Protocol Determinant Descriptor Determinant Number Level 5 Back Pain Alpha 17 Fall Alpha / Bravo 21 Hemorrhage/Lacerations Alpha / Bravo 26 Sick Call Alpha 29 Traffic/Transportation Incident Alpha / Bravo 30 Traumatic Incidents Alpha / Bravo Free-Lancing – BLS units may request to respond to any call that they are the closest to regardless of the determinant level. However, under no circumstance shall an Advanced Life Support (ALS) ambulance request a BLS unit to dual respond without the permission of the EMS Supervisor. BLS units shall not request an ALS unit while responding without the permission of the EMS Supervisor. BLS units may request an ALS unit after evaluating the patient and determining ALS is needed. (It is important for the second ambulance dispatched to a cardiac arrest be an advanced life support asset) RESPONSE During responses to the call determinants above, the BLS unit shall respond to the scene and provide patient evaluation PRIOR to requesting advance life support. Should additional information be obtained during the EMD of the 911 call that indicates a need for ALS level response, an EMS Supervisor will be notified. If a BLS unit is being dispatched to a non-BLS call and there are no ALS units available, the standard response will include the closest ALS Supervisor. Page 2 of 5 Orange County Emergency Services Basic Life Support Ambulance and Response October 1, 2018 Once on scene and after the patient is determined to require advanced life support assessment and/or treatment, the BLS unit shall contact the Emergency Communications Division via the appropriate Operations Channel to request ALS assistance. The EMS Supervisor must be aware of all dual dispatch of units. In situations where the ALS unit is not available, the closest EMS Supervisor will respond and serve as the ALS provider . In most cases, it will be appropriate for the BLS crew to begin packaging the patient and initiate transport to the most appropriate hospital. Prior to leaving the call location, alert the ALS responding unit to determine if transport to the appropriate hospital is closer than the arrival time of the ALS provider or if an intercept would be a better option. DOCUMENTATION ESO Solutions have been updated to allow for Basic Life Support units as a designation. It is important to properly log in at the beginning of the shift as the appropriate unit with certification level as well as the correct shift. As with all advanced life support patient care records, the appropriate sections must be completed based on the initial training. This includes a thorough narrative based on the highest scope of practice in D-CHARTE format. A minimum of two complete vital signs are required. Vital signs include blood pressure, pulse rate, respiratory rate, pulse oximetry, and Glasgow Coma Scale. In addition, blood glucose and temperature must be obtained. If an EMS Supervisor arrives on the call and assumes patient care, they must be added to the call as the lead. The narrative may be initiated by the BLS crew, but the EMS Supervisor must review the chart once synchronized (not locked) in ESO Solutions and add their findings and actions taken. The ALS provider is responsible for the patient care record. Refusal of Care / Transportation The BLS unit may accept patient care and transport refusals. However, if under any circumstances, the crew does not agree with the patient or each other or if they feel that the patient is considered a high-risk refusal as defined by their experience, they should contact the EMS Supervisor. The EMS Supervisor may choice to respond, dispatch an advanced life support unit, or converse with the patient and/or family to remedy the situation after consultation with the BLS crew. Should the patient ultimately refuse care and/or transport, the following is an example of the appropriate language you could use in the narrative: REFUSAL OF CARE AND TRANSPORT: The patient decided to refuse care which consisted of (Specify Care) and/or transport to the hospital of their choice. The patient was found alert and oriented to person, place, time and situation at time of refusal. Further, we discussed several items that are consistent with someone who may demonstrate decisional capacity, such as; 1) Communicated a choice = The patient actively declined treatment and/or transport in their own Page 3 of 5 Orange County Emergency Services Basic Life Support Ambulance and Response October 1, 2018 words, 2) Understood relevant information = The patient expressed in their own words the medical crisis at hand and risks/benefits of medical treatment after discussion with OCES Paramedic, 3) Appreciated the situation = The patient described their view of their medical condition and, 4) Reasoning about treatment/transport options = The patient’s criterion for making their decision appeared reasonable. An OCES Emergency Services Referral form was provided to the patient/surrogate. The appropriate signature was obtained in the ESO Solutions mask for this patient. QUALITY ASSURANCE All quality assurance begins with each staff member as they complete their patient care records. The patient care records are required to be completed by the end of shift. They are to be reviewed by each member, locked and synchronized in ESO Solutions unless otherwise specified by the EMS Supervisor. The EMS Supervisor for that shift will be responsible for reviewing one hundred percent of the patient care records for the BLS units. The BLS records may not be delegated to the Field Training Officers for review unless directed by the EMS Operations Manager or their designee. The Quality Assurance Officer will review all basic life support calls and share their findings with EMS Operations Manage, or their designee, and the Medical Director at the Quarterly Quality Assurance Meeting unless a gross violation was determined at which time, both the EMS Operations Manager and Medical Director will be notified at once. EQUIPMENT All in-service Orange County ambulances are outfitted for advanced life support level. In the case a basic life support ambulance being placed in service, the crew shall use the equipment appropriate to their scope of practice and MUST not use any medication or equipment they are not qualified to use. LifePak 15 – The LifePak 15 monitor / defibrillator can be used in Automatic External Defibrillation mode and shall be brought in on all patient care contacts. A BLS provider may transmit a 12-lead tracing For suspected STEMI. Meret Pack – The Meret Pack contains appropriate airway and respiratory equipment suitable for use at the BLS level. CPAP BVM Capnography Colorimetric Device King Airway Oral and Nasal Airways Page 4 of 5 Orange County Emergency Services Basic Life Support Ambulance and Response October 1, 2018 Manual Blood Pressure Cuff and Stethoscope Diabetic Kit (Oral Glucose only) Tourniquet Thermometer Isolation Kit Limb Restraints In addition, the Meret Bag carries the drug module that contains the following medication that may be used by EMTs in specific protocols.
Recommended publications
  • NIMS 508 Stillwater Flood Search and Rescue Team
    Resource Typing Definition for Response Mass Search and Rescue Operations STILLWATER/FLOOD SEARCH AND RESCUE TEAM DESCRIPTION The Stillwater/Flood Search and Rescue (SAR) Team conducts search, rescue, and recovery operations for humans and animals in stillwater and stillwater/flood environments RESOURCE CATEGORY Search and Rescue RESOURCE KIND Team OVERALL FUNCTION The Stillwater/Flood SAR team: 1. Searches for and rescues individuals who may be injured or otherwise in need of medical attention 2. Provides emergency medical care, including Basic Life Support (BLS) 3. Provides animal rescue 4. Transports humans and animals to the nearest location for secondary land or air transport 5. Provides shore-based and boat-based water rescue for humans and animals 6. Supports helicopter rescue operations and urban SAR in water environments for humans and animals 7. Operates in environments with or without infrastructure, including environments with disrupted access to roadways, utilities, transportation, and medical facilities, and with limited access to shelter, food, and water COMPOSITION AND ORDERING 1. Requestor and provider address certain needs and issues prior to deployment, including: SPECIFICATIONS a. Communications equipment that enables more than intra-team communications, such as programmable interoperable communications equipment with capabilities for command, logistics, military, air, and so on b. Type of incident and operational environment, such as weather event, levy or dam breach, or risk of hazardous materials (HAZMAT) contamination c. Additional specialized personnel, such as advanced medical staff, animal SAR specialists, logistics specialists, advisors, helicopter support staff, or support personnel for unique operating environments d. Additional transportation-related needs, including specific vehicles, boats, trailers, drivers, mechanics, equipment, supplies, fuel, and so on e.
    [Show full text]
  • Basic Life Support Health Care Provider
    ELLIS & ASSOCIATES Health Care Provider Basic Life Support MEETS CURRENT CPR & ECC GUIDELINES Ellis & Associates / Safety & Health HEALTH CARE PROVIDER BASIC LIFE SUPPORT - I Ellis & Associates, Inc. P.O. Box 2160, Windermere, FL 34786-2160 www.jellis.com Copyright © 2016 by Ellis & Associates, LLC All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher, addressed “Attention: Permissions Coordinator,” at the address below. Ellis & Associates P.O. Box 2160, Windermere, FL 34786-2160 Ordering Information: Quantity sales. Special discounts are available on quantity purchases by corporations, associations, trade bookstores and wholesalers. For details, contact the publisher at the address above. Disclaimer: The procedures and protocols presented in this manual and the course are based on the most current recommendations of responsible medical sources, including the International Liaison Committee on Resuscitation (ILCOR) 2015 Guidelines for CPR & ECC. Ellis & Associates, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency, or completeness of such recommendations or information. Additional procedures may be required under particular circumstances. Ellis & Associates disclaims all liability for damages of any kind arising from the use of, reference to, reliance on, or performance based on such information. Library of Congress Cataloging-in-Publication Data Not Available at Time of Printing ISBN 978-0-9961108-0-8 Unless otherwise indicated on the Credits Page, all photographs and illustrations are copyright protected by Ellis & Associates.
    [Show full text]
  • Issue 117 Autumn 2015 Issn 0965-1128 (Print) Issn 2045-6808 (Online)
    ISSUE 117 AUTUMN 2015 ISSN 0965-1128 (PRINT) ISSN 2045-6808 (ONLINE) THE MAGAZINE OF THE SOCIETY FOR ENDOCRINOLOGY Education and Careers Securing your dream job in endocrinology SPECIAL FEATURES PAGES 7–15 An interview with… LESLEY REES P25–27 Do-it-yourself Multiple choice madness? SET UP YOUR OWN ENDOCRINE SOCIETY WHY ‘FAIR’ EXAMS MUST CHANGE P21 P16 MAKING AN THE ‘FUTURES’ GOING OUT WITH IMPACT ARE BRIGHT! A BANG Success for Society New sessions at Taking endocrinology to journals SfE BES 2015 schoolchildren P3 P19 P20 www.endocrinology.org/endocrinologist WELCOME Editor: Dr Miles Levy (Leicester) Associate Editor: Dr Tony Coll (Cambridge) A WORD FROM Editorial Board: Dr Rosemary Bland THE EDITOR… Dr Dominic Cavlan (London) Dr Paul Foster (Birmingham) Dr Paul Grant (London) Managing Editor: Dr Jennie Evans Sub-editor: Caroline Brewser Design: Corbicula Design Society for Endocrinology The Endocrinologist 22 Apex Court, Woodlands, Welcome to this grass roots edition of , which covers the subject of how to navigate Bradley Stoke, Bristol BS32 4JT, UK a career in endocrinology. At every stage we all need career progression, no matter how junior or Tel: 01454 642200 senior we are. There have been numerous changes to clinical training (not all good), and there are Email: [email protected] Web: www.endocrinology.org serious workforce issues in hospital medicine. Having a senior mentor to guide us through our career Company Limited by Guarantee is vital, and this seems to be increasingly difficult to achieve. There are career challenges to basic Registered in England No. 349408 scientists too, and we have included several articles that hopefully will give good advice and ideas Registered Office as above Registered Charity No.
    [Show full text]
  • Initial Capnography Values and Resuscitation Outcomes of Patients Assisted by Basic Life Support Units in First Instance
    Submitted: 09 December, 2020 Accepted: 05 February, 2021 Published: 08 July, 2021 DOI:10.22514/sv.2021.099 ORIGINALRESEARCH Initial capnography values and resuscitation outcomes of patients assisted by basic life support units in first instance; descriptive prospective study Francisco José Cereceda-Sánchez1;*, Jaume Ponce-Taylor1, Pedro Montero-París1, Iñaki Unzaga-Ercilla1, Natalia Martinez-Cuellar1, Jesús Molina-Mula2 1SAMU 061 Baleares, C/Illes Balears sn. Abstract Palma de Mallorca, 07014, Spain Introduction: Understanding the key factors which affect out hospital cardiac arrest 2Phd Department of Nursing and Physiotherapy University of Balearic (OHCA) outcomes is essential in order to promote patient treatment. The main Islands, Ctra. De Valldemossa, km 7,5 objective of this research was to describe the correlations between the capnographic Palma de Mallorca (Islas Baleares), values obtained during the first minute of monitoring on cardiopulmonary resuscitation, 07122, Spain assisted by basic life-support units, with the results as return of spontaneous circulation *Correspondence (ROSC) and alive hospital admission. The secondary objectives were to describe the [email protected] sociodemographic characteristics of the patients assisted, and to analyze any correlations (Francisco José Cereceda-Sánchez) between receiving basic life-support units and/or defibrillation prior to the arrival of basic life-support units, and the results of the cardiopulmonary resuscitation maneuvers. Methods: A prospective, descriptive, observational study of adult non-traumatic out hospital cardiac arrest patients was conducted. The patients were initially assisted by basic life-support units on the island of Mallorca, with one minute of initial capnography monitoring. Results: From July 2018 to March 2020, fifty-nine patients meeting the inclusion criteria were assisted, 76% were men and their mean age was 64.45 (15.07) years old.
    [Show full text]
  • NYS CFR Protocols
    New York State Department of Health Bureau of Emergency Medical Services Statewide Basic Life Support Adult & Pediatric Treatment Protocols Certified First Responder 2003 = Preface and Acknowledgments The 2003 New York State (NYS) Statewide Basic Life Support Adult & Pediatric Treatment Protocols for the Certified First Responder (CFR) includes revisions to match the current New York State CFR course curricula. These 2003 statewide protocols also include de- emphasizing the use of CUPS. CUPS is no longer required to be taught in NYS Emergency Medical Services (EMS) Courses and is not tested in Practical Skills Examinations or State Written Certification Examinations. We would like to acknowledge the members of the New York State EMS Council’s Medical Standards Committee for the time and effort given to developing this set of protocols. In addition, we would like to recognize the efforts of the Regional Emergency Medical Advisory Committees (REMACS) for their input and review. Mark Henry, MD, FACEP Medical Director Edward Wronski, Director State Emergency Medical Advisory Committee Bureau of Emergency Medical Services NYS CFR Basic Life Support Protocols NYS CFR Basic Life Support Protocols Introduction The 2003 NYS Statewide Basic Life Support Adult and Pediatric Treatment Protocols designed by the Bureau of Emergency Medical Services of the New York State Department of Health and the New York State Emergency Medical Services Council. These protocols have been reviewed and approved by the New York State Emergency Medical Advisory Committee (SEMAC) and the New York State Emergency Medical Services Council (SEMSCO). The protocols reflect the current minimally acceptable statewide treatment standards for adult and pediatric basic life support (BLS) used by the Certified First Responder (CFR).
    [Show full text]
  • Mos Specific Requirements
    IOWA ARMY NATIONAL GUARD NON STANDARD VACANCY ANNOUNCEMENT POSITION VACANCY NUMBER: 21-019 CLOSING DATE: Indefinite UNIT/DUTY LOCATION: HHB 194th FA / Fort Dodge MINIMUM RANK TO APPLY: SSG DUTY MOS: 68W4O DUTY POSITION: Platoon Sergeant FULL-TIME STAFF POC: SFC Dana Preuschl PHONE: (515) 576-3761 LEADERSHIP POSITION/TYPE: Yes / Platoon Sergeant ELIGIBILITY REQUIREMENTS TO BE CONSIDERED FOR THIS POSITION GENERAL REQUIREMENTS: 1. Not currently “Flagged from Favorable Personnel Actions” or under a “Bar to Reenlistment.” 2. Must be or be able to complete 68W MOSQ within 12 months of assignment. 3. Must be able to meet the required service obligation (minimum of 12 months from course completion). 4. A Soldier who has a remaining contractual service obligation due to an incentive contract for a specific MOS or UIC may apply for non-standard vacancies, but will lose remaining incentive payments with the possibility of recoupment, as applicable. 5. Must not be currently stagnant on NCOES/PME. (to include DLC requirements). 6. Soldiers command removed or self-removed from promotion consideration are not eligible to apply. MOS SPECIFIC REQUIREMENTS: 1. A physical demands rating of Significant (Gray). 2. PULHES: 111121. 3. No aversion to blood. 4. Must possess finger dexterity in both hands. 5. A security eligibility of SECRET is required for the initial award and to maintain the MOS. 6. A minimum score of 105 in aptitude area ST and 110 in aptitude area GT in Armed Services Vocational Aptitude Battery (ASVAB) tests administered prior to 2 January 2002. 7. A minimum score of 102 in aptitude area ST and 110 in aptitude area GT on ASVAB tests administered on and after 2 January 2002 and prior to 1 July 2004.
    [Show full text]
  • Basic Life Support Patient Care Standards
    This document contains both information and navigation buttons. To read information, use the Down Arrow from a form field. Basic Life Support Patient Care Standards Version 3.0.1 Comes into force December 11, 2017 Emergency Health Services Branch Ministry of Health and Long-Term Care To all users of this publication: The information contained in the Standards has been carefully compiled and is believed to be accurate at date of publication. For further information on the Basic Life Support Patient Care Standards, please contact: Emergency Health Services Branch Ministry of Health and Long-Term Care 5700 Yonge Street, 6th Floor Toronto, ON M2M 4K5 416-327-7900 © Queen’s Printer for Ontario, 2016 Document Control Version Date of Issue Comes into Force Brief Description of Change Number Date 3.0 July 2016 N/A (amended prior Full update. See accompanying training to in force date) bulletin for further details 3.0.1 November 2016 December 11, 2017 Update to Paramedic Prompt Card for Acute Stroke Protocol: Contraindication changed from “CTAS Level 2” to “CTAS Level 1”. Table of Contents Preamble ............................................................................................................................. 7 Preface............................................................................................................................................. 1 Definitions....................................................................................................................................... 1 Introduction ....................................................................................................................................
    [Show full text]
  • Basic Life Support 1 1.2 Advanced Life Support 5
    RESUSCITATION Edited by Conor Deasy SECTION 1 1.1 Basic life support 1 1.2 Advanced life support 5 1.1 Basic life support Sameer A. Pathan compressions and rapid defibrillation, which ESSENTIALS significantly improves the chances of survival from ventricular fibrillation (VF) in OHCA.1–3 CPR 1 A patient with sudden out-of-hospital cardiac arrest (OHCA) requires activation of plus defibrillation within 3 to 5 minutes of collapse the Chain of Survival, which includes early high-quality cardiopulmonary resuscitation following VF in OHCA can produce survival rates (CPR) and early defibrillation. The emergency medical dispatcher plays a crucial and as high as 49% to 75%.5–7 Each minute of delay central role in this process. before defibrillation reduces the probability of survival to hospital discharge by 10% to 12%.2,3 2 Over telephone, the dispatcher should provide instructions for external chest The final links in the Chain of Survival are effec- compressions only CPR to any adult caller wishing to aid a victim of OHCA. This approach tive ALS and integrated post-resuscitation care has shown absolute survival benefit and improved rates of bystander CPR. targeted at optimizing and preserving cardiac 8 3 In the out-of-hospital setting, bystanders should deliver chest compressions to any and cerebral function. unresponsive patient with abnormal or absent breathing. Bystanders who are trained, able, and willing to give rescue breaths should do so without compromising the main focus on high quality of chest compressions. Development of protocols Any guidelines for BLS must be evidence based 4 Early defibrillation should be regarded as part of Basic Life Support (BLS) training, as and consistent across a wide range of providers.
    [Show full text]
  • Job Description: Medic One Operations Captain
    CITY OF BELLINGHAM JOB DESCRIPTION JOB TITLE: Medic One Operations Captain UNION:106 SG:32 CLASS TITLE: EMS Captain CS:P FLSA:Y DEPARTMENT: Fire EEO4CODE:PR JOB SUMMARY: The Medic One Operations Captain assists the Medical Services Officer (MSO) in the development and administration of the Department’s emergency medical quality control and medical education programs. The person in this position supervises Department personnel in the delivery of emergency medical services and manages Medic One equipment and supplies needs. Works closely and coordinates with Fire and EMS Captains, Battalion Chiefs and requires frequent contact with all first response EMS agencies in the County. The person in this position may also assist with or be assigned to other positions within the EMS Captain classification. SUPERVISORY RELATIONSHIP: Reports directly to the Medical Services Officer and on-duty Operations Battalion Chief. Directly supervises Department personnel assigned to county medic unit stations, and all other Department personnel who deliver emergency medical services and works closely with Fire and other EMS Captains to coordinate these services and activities. ESSENTIAL FUNCTIONS OF THE JOB: 1. Reviews all Medical Incident Reports (MIRS) on a daily basis for written compliance with medical protocols and Whatcom Medic One performance standards. Makes comments as necessary, with follow up provided to the paramedic, fire district, Medical Director and MSO as appropriate. 2. Monitors personnel for their compliance with emergency medical standards. Conducts or participates in medical performance evaluations of EMT (Emergency Medical Technician) and paramedic staff. Initiates disciplinary action when necessary. 3. Provides feedback to all first response agencies on their field performance or other issues as necessary.
    [Show full text]
  • Part 2: Adult Basic Life Support
    Resuscitation (2005) 67, 187—201 Part 2: Adult basic life support International Liaison Committee on Resuscitation The consensus conference addressed many decrease interruptions in compressions.During questions related to the performance of basic two-rescuer CPR of the infant or child, health- life support.These have been grouped into (1) care providers should use a 15:2 compression— epidemiology and recognition of cardiac arrest, ventilation ratio. (2) airway and ventilation, (3) chest compression, • During CPR for a patient with an advanced air- (4) compression—ventilation sequence, (5) postre- way (i.e. tracheal tube, Combitube, laryngeal suscitation positioning, (6) special circumstances, mask airway [LMA]) in place, deliver ventilations (7) emergency medical services (EMS) system, at a rate of 8—10 per min for infants (excepting and (8) risks to the victim and rescuer.Defibril- neonates), children and adults, without pausing lation is discussed separately in Part 3 because during chest compressions to deliver the ventila- it is both a basic and an advanced life support tions. skill. There have been several important advances in the science of resuscitation since the last ILCOR Epidemiology and recognition of cardiac review in 2000.The following is a summary of the arrest evidence-based recommendations for the perfor- mance of basic life support: Many people die prematurely from sudden cardiac arrest (SCA), often associated with coronary heart • Rescuers begin CPR if the victim is unconscious, disease.The following section summarises the bur- not moving, and not breathing (ignoring occa- den, risk factors, and potential interventions to sional gasps). reduce the risk. • For mouth-to-mouth ventilation or for bag-valve- mask ventilation with room air or oxygen, the res- Epidemiology cuer should deliver each breath in 1 s and should see visible chest rise.
    [Show full text]
  • Basic Life Support Health Care Provider
    ELLIS & ASSOCIATES Health Care Provider Basic Life Support MEETS CURRENT CPR & ECC GUIDELINES Ellis & Associates / Safety & Health HEALTH CARE PROVIDER BASIC LIFE SUPPORT - I Ellis & Associates, Inc. P.O. Box 2160, Windermere, FL 34786-2160 www.jellis.com Copyright © 2016 by Ellis & Associates, LLC All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other noncommercial uses permitted by copyright law. For permission requests, write to the publisher, addressed “Attention: Permissions Coordinator,” at the address below. Ellis & Associates P.O. Box 2160, Windermere, FL 34786-2160 Ordering Information: Quantity sales. Special discounts are available on quantity purchases by corporations, associations, trade bookstores and wholesalers. For details, contact the publisher at the address above. Disclaimer: The procedures and protocols presented in this manual and the course are based on the most current recommendations of responsible medical sources, including the International Liaison Committee on Resuscitation (ILCOR) 2015 Guidelines for CPR & ECC. Ellis & Associates, however, make no guarantee as to, and assume no responsibility for, the correctness, suiciency, or completeness of such recommendations or information. Additional procedures may be required under particular circumstances. Ellis & Associates disclaims all liability for damages of any kind arising from the use of, reference to, reliance on, or performance based on such information. Library of Congress Cataloging-in-Publication Data Not Available at Time of Printing ISBN 978-0-9961108-0-8 Unless otherwise indicated on the Credits Page, all photographs and illustrations are copyright protected by Ellis & Associates.
    [Show full text]
  • Emerging Uses of Capnography in Emergency Medicine in Emergency Capnography Uses of Emerging
    Emerging Uses of Capnography in Emergency Medicine WHITEPAPER INTRODUCTION The Physiologic Basis for Capnography Capnography is based on a discovery by chemist Joseph Black, who, in 1875, noted the properties of a gas released during exhalation that he called “fixed air.” That gas—carbon dioxide (CO2)—is produced as a consequence of cellular metabolism as the waste product of combining oxygen and glucose to produce energy. Carbon dioxide exits the body via the lungs. The concentration of CO2 in an exhaled breath reflects cardiac output and pulmonary blood flow as the gas is transported by the venous system to the right side of the heart and then pumped into the lungs by the right ventricle. Capnographs measure the concentration of CO2 at the end of each exhaled breath, commonly known as the end- tidal carbon dioxide (EtCO2). As long as the heart is beating and blood is flowing, CO2 is delivered continuously to the lungs for exhalation. An EtCO2 value outside the normal range in a patient with normal pulmonary blood flow indicates a problem with ventilation that may require immediate attention. Any deviation from normal ventilation quickly changes EtCO2, even when SpO2—the indirect measurement of oxygen saturation in the blood—remains normal. Thus, EtCO2 is a more sensitive and rapid indicator of ventilation problems than SpO2.1 Why EtCO2 Monitoring Is Important It is generally accepted that EtCO2 monitoring is the practice standard for determining whether endotracheal tubes are correctly placed. However, there are other important indications for its use as well. Ventilatory monitoring by EtCO2 measurement has long been a standard in the surgical and intensive care patient populations.
    [Show full text]