Protocols

Question 1

Pain Management

Answer 1

Entonox, Acetaminophen, and/or Ibuprofen

Question 2

Anaphylaxis

Answer 2

Epinephrine

Question 3

Cardiac Chest Pain

Answer 3

ASA and Nitroglycerin/Entonox

Question 4

Respiratory Arrest

Answer 4

Protect ABC’s, Ventilate w. BVM, High flow Oxygen

Question 5

Diabetic Emergencies

Answer 5

Oral Glucose IF patient is able to maintain airway
/Glucagon IF patient is unable to maintain airway

Question 6

Hypothermia

Answer 6

*Asses and mainatain ABCs as necessary.
*Take up 30-45 seconds to determine pulselessness in the severe hypothermic pt.
*remove wet clothing and cover with blankets or dry clothing.
*Take temperature if appropriate.
*In the event of cardiac arrest apply AED and analyze, defibrillate up to three times
if indicated, continue with CPR and rapid transport to the hospital. (After three
defibrillations, do not pause CPR for analyzing or shocks)

Question 7

Shortness of Breath - COPD/Asthma

Answer 7

Salbutamol

Question 8

Narcotic Overdose

Answer 8

Naloxone/Narcan

Question 9

Cardiac Arrest

Answer 9

Prioritize CAB, Compressions, Airway, Breathing, High-flow O2 w. BVM, AED, 30:2, 100-120 compression, 2 minutes or 5 cycles

Question 10

Altered Mental Status

Answer 10

Check BGL

Question 11

Moderate Hypothermia
> 32d and < 35d

Answer 11

Actively Rewarm patient.

• Mild activity (if appropriate)
• Preheat the interior of the ambulance to 30C
• Use hot packs wrapped in towels
• Warm blankets

Question 12

Severe Hypothermia
< 28d

Answer 12

DO NOT ACTIVELY REWARM PATIENT.

• Insulate the patient to prevent further heat loss
• Heat ambulance to 30oC
• Avoid rough handling

Question 13

Stroke Indications

Answer 13

• Any neurological deficits
• Altered LOC or unconscious
• Difficulty maintaining airway
• Shortness of breath, noisy or absent respirations
• Weak, rapid or absent radial pulse

Question 14

Stroke Interventions

Answer 14

• Assess and manage ABCs as required
• Provide supplemental oxygen to maintain SpO2 ≥ 94%
• Position of patient
• Blood glucose check (key symptom of stroke if BGL comes back > 4)
• Accurate recognition (FAST-VAN)
• Timely Transport, Notify receiving facility while en route
• BGL must be done on primary survey after RBS

Question 15

Accurate Recognition of (FAST SCREEN)

Answer 15

If BGL is > 4

Face: R droop L droop or normal?
Arm: R weak L weak or normal?
Speech: Slurred or normal?
Time: < 6hrs or woke with Symptoms (outside window?)

Question 16

Accurate recognition of (VAN SCREEN)

Answer 16

Vision: R gaze L gaze or normal?
Aphasia: Naming difficulties or normal?
Neglect: Ignoring left body or normal?

Question 17

One or more VAN yes/no notification

Answer 17

No VAN symptoms: *Continue as per local stroke bypass protocol.
*Notify ER Triage THIS IS A STROKE ALERT

Yes to one or more VAN symptoms:
*Continue as per local stroke bypass protocol.
*Notify ER Triage THIS IS A STROKE ALERT WITH POSSIBLE LARGE VESSEL OCCLUSION
refer to pg 31

Question 18

Congestive Heart Failure or Pulmonary Edema
Indications

Answer 18

• Drowning
• Congested Heart Failure
• Cardiogenic shock
• Exposure to toxins
• Lower extremity edema?

Question 19

Congestive Heart Failure or Pulmonary Edema Interventions

Answer 19

• Keep the patient at rest and avoid exertion during transfers. Bring equipment to
  the patient, including lifting and transfer devices.
• Position patient sitting upright with legs hung down.
• Keep the patient warm and protect from further heat loss
• Provide supplemental oxygen to keep SpO2 ≥ 94%
• Assist ventilations if altered LOC or SpO2 <94%

Question 20

unresponsive pt

Answer 20

check CAB
BGL
PUPILS

Question 21

Wheezing on Expiration

Answer 21

Bronchospasm
Problems pushing air out

salbutamol