Protocols

Question 1

Medical Cardiac Arrest Protocol

Answer 1

• Indications: PT is in cardiac arrest
• Contraindications: VERIFIABLE Do Not Resuscitate (DNR) or No CPR orders, and Obvious Death
• Cautions: Cardiac arrest w/ treatable causes (see cardiac arrest overview)

Note: Full protocols were too complex to easily turn into flashcards, as such you will have to find and study them from the JIBC EMR TT&P

Question 2

Traumatic Cardiac Arrest Protocol

Answer 2

• Indications: PT is in Cardiac Arrest due to to trauma related causes
• Contraindications: VERIFIABLE Do Not Resuscitate (DNR) or No CPR orders, obvious death, medical cardiac arrest PT who has sustained trauma

Question 3

Discontinue CPR

Answer 3

• Indications: PT in cardiac arrest who has not responded to CPR & AED interventions
• Contraindications: Children & Hypothermic PTs

Question 4

Pain Management

Answer 4

• Indications: Pain
• Contraindications: Entonox: Pneumothorax, Air Embolism, Inhalation Injury, Nitro in last 5 mins, Decompression Illness, Inability to Comply, Enclosed Space
• Cautions: Entonox: Shock, Abdominal Distention, Depressant Drugs, Maxillo Facial Injuries, COPD

Question 5

Chest Pain

Answer 5

• Indications: PT whose presentation is suggestive of cardiac chest pain
• Contraindications:
  1. ASA (Aspirin): Allergy/hypersensitivity to Aspirin, Pediatric PT, Asthma Exacerbation, Acute bleed, and Dose
  2. Nitroglycerin: Allergy or sensitivity to Nitrates, SYS BP < 110mmHg, Viagra/Levitra <24 hrs, or Calais <48 hrs
• Cautions:
  1. ASA (Aspirin): Recent internal bleeding, known bleeding diseases, currently taking anticoagulants, recent surgery, possibility of pregnancy
  2. Nitroglycerin: Hypotension (fall risk)

Question 6

Diabetic

Answer 6

• Indications: PT w/ decreased LOC whose history suggests hyper/hypoglycemia
• Contraindications:
  1. Oral administration: PT is unable to maintain their own airway, sit & follow commands
  2. Buccal Administration: PT must be placed semi-prone position prior to administration; if this position cannot be achieved due to other related complications, administration is contraindicated due to the possibility of aspiration
• Cautions: Monitor closely for airway complications

Question 7

Narcotic Overdose

Answer 7

• Indications: Decreased lvl of responsiveness, Respiratory depression requiring BVM, Signs & symptoms suggestive of narcotic overdose
• Contraindications: known allergy to Naloxone, Neonate (0-28 days)
• Cautions: May precipitate withdrawal symptoms
  1. Naloxone: Patient Combativeness