Utah EMS Protocol Guidelines January 2020 Revised: 01/06/2021 Table of Contents General Patient Care Guidelines ................................................................................................................... 6 AIRWAY AND TRACHEOSTOMY MANAGEMENT ........................................................................................... 7 ALTERED MENTAL STATUS .......................................................................................................................... 10 DEATH DETERMINATION AND TERMINATION OF RESUSCITATION ............................................................ 12 FAMILY CENTERED CARE ............................................................................................................................. 14 NAUSEA / VOMITING .................................................................................................................................. 15 PAIN & ANXIETY MANAGEMENT ................................................................................................................ 16 PEDIATRIC ASSESSMENT ............................................................................................................................. 19 SHOCK, SEPSIS, & FLUID THERAPY .............................................................................................................. 20 Cardiac Patient Care Guidelines .................................................................................................................. 22 CARDIAC ARREST ......................................................................................................................................... 23 BRADYCARDIA (Symptomatic) .................................................................................................................... 26 CARDIAC CHEST PAIN (ACUTE CORONARY SYNDROME) ............................................................................ 28 CONGESTIVE HEART FAILURE / PULMONARY EDEMA ................................................................................ 30 NEWBORN RESUSCITATION ........................................................................................................................ 32 POST CARDIAC ARREST ............................................................................................................................... 34 RETURN OF SPONTANEOUS CIRCULATION (ROSC) ..................................................................................... 34 TACHYCARDIA (With a Pulse) ...................................................................................................................... 35 Medical Patient Care Guidelines ................................................................................................................. 37 ALLERGIC REACTION / ANAPHYLAXIS.......................................................................................................... 38 DROWNING OR SUBMERSION .................................................................................................................... 40 FEVER MANAGEMENT ................................................................................................................................ 42 GLUCOSE EMERGENCIES ............................................................................................................................. 43 OBSTETRICAL EMERGENCIES ...................................................................................................................... 45 OPIOID OVERDOSE ...................................................................................................................................... 47 RESPIRATORY DISTRESS .............................................................................................................................. 49 SEIZURES ..................................................................................................................................................... 51 SUSPECTED STROKE .................................................................................................................................... 53 TEMPERATURE AND ENVIRONMENTAL EMERGENCIES .............................................................................. 56 TOXIC EXPOSURE - CARBON MONOXIDE .................................................................................................... 58 TOXIC EXPOSURE - CYANIDE ....................................................................................................................... 59 TOXIC EXPOSURE - HYDROFLUORIC ACID ................................................................................................... 60 TOXIC EXPOSURE - ORGANOPHOSPHATES / NERVE AGENTS ..................................................................... 61 2020 Utah EMS Protocol Guidelines 2 VIOLENT PATIENT / CHEMICAL SEDATION / TASER BARB REMOVAL ......................................................... 62 Trauma Patient Care Guidelines ................................................................................................................. 64 Utah Trauma System Advisory Committee ................................................................................................. 66 GENERAL TRAUMA MANAGEMENT ............................................................................................................ 67 AMPUTATIONS / TOOTH AVULSIONS ......................................................................................................... 69 BURNS – THERMAL / ELECTRICAL / LIGHTNING.......................................................................................... 70 HEAD INJURY (TRAUMATIC BRAIN INJURY) ................................................................................................ 73 HEMORRHAGE CONTROL, EXTREMITY AND CRUSH INJURIES .................................................................... 75 NON-ACCIDENTAL TRAUMA/ABUSE ........................................................................................................... 77 SNAKE BITES ................................................................................................................................................ 78 SPINAL MOTION RESTRICTION (SMR) ......................................................................................................... 79 Appendix 1 .................................................................................................................................................. 81 Acetaminophen (Tylenol) ......................................................................................................................... 83 Adenosine (Adenocard) ............................................................................................................................ 83 Albuterol (Ventolin/Proair/Proventil) ..................................................................................................... 84 Amiodarone Hydrochloride (Cordarone) ............................................................................................... 84 Aspirin (Ecotrin) ....................................................................................................................................... 85 Atropine ..................................................................................................................................................... 86 Calcium Chloride/ Calcium Gluconate ................................................................................................... 87 Diazepam (Valium) ...................................................................................................................................... 88 Diphenhydramine (Benadryl) .................................................................................................................. 89 Dextrose ..................................................................................................................................................... 89 Epinephrine (Adrenaline) ........................................................................................................................ 90 Epinephrine – “Push Dose” Pressor Administration ............................................................................. 91 Glucagon (GlucaGen) ............................................................................................................................... 93 Oral Glucose .............................................................................................................................................. 94 Ibuprofen (Motrin/Advil) ......................................................................................................................... 94 Ipratropium (Atrovent) ............................................................................................................................ 95 Ketamine HCL .......................................................................................................................................... 95 Ketorolac (Toradol) .................................................................................................................................. 97 Lidocaine .................................................................................................................................................... 97 Lorazepam ................................................................................................................................................. 98 Magnesium Sulfate 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