Table Of Content

EMERGENCY MEDICAL SERVICES PRE-HOSPITAL TREATMENT PROTOCOLS MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH OFFICE OF EMERGENCY MEDICAL SERVICES 56 Roland Street, Suite 100 BOSTON, MA 02129 (617)284-8300 www.state.ma.us/dph/oems DATE DUE MASS KFM 2763 .E43 M374 200 Massachusetts. Office of Emergency Medical Services. Enmrepr-ghenn<;cnyi mre^ld i ctarle a tsmeernvti ces c DATE DUE BORROWER'S NAME llASSnCFM 2763 .E43 H374 200 Massachusetts. Office of Emergency Medical Services. Emergency medical services ore-hosTpHiItSa l M A tYr e aBtEm e KnEtP T 7 DAYS ONLY IT CANNOT BE RENEWED OR TRANSFERRED COMMONWEALTH OF MASSACHUSETTS HAMPSHIRE LAW LIBRARY COURTHORSE- 99 MAIN STREET NORTHAMPTON, MASS. 01060 DEMCO TABLE OF CONTENTS ACKNOWLEDGMENTS INTRODUCTION & GENERAL POLICIES PROTOCOLS 1. CARDIAC EMERGENCIES 1.1 Asystole (Cardiac Arrest) 1.2 Atrial Fibrillation 1.3 Atrial Flutter 1 .4 Bradydysrhythmias 1.5 Chest Pain 1 .6 Post-Resuscitation Care 1 .7 Premature Ventricular Contractions 1 .8 Pulseless Electrical Activity (Cardiac Arrest) 1 .9 Supraventricular Tachycardia 1.10 Ventricular Fibrillation / P ulseless Ventricular Tachycardia (Cardiac Arrest) 1.11 Ventricular Tachycardia with Pulses 2. ENVIRONMENTAL EMERGENCIES 2.1 Drowning and Near-Drowning Emergencies 2.2 Electrocution / L ightning Injuries 2.3 Hyperthermia / H eat Emergencies 2.4 Hypothermia / C old Emergencies 2.5 Radiation Injuries 3. MEDICAL EMERGENCIES 3.1 Abdominal Pain 3.2 Allergic Reactions / A naphylaxis 3.3 Altered Mental Status / D iabetic 3.4 Bronchospasm / R espiratory Distress 3.5 Congestive Heart Failure / P ulmonary Edema 3.6 Eye Emergencies 3.7 Hypertensive Emergencies 3.8 Obstetrical Emergencies 3.9 Seizures 3.10 Shock (Hypoperfusion) of Unknown Etiology 3.1 1 Syncope of Unknown Etiology 3. 1 2 Toxicology / P oisoning / S ubstance Abuse / O verdose Third Edition 11/1/00 I I I I I I I I I PROTOCOLS 4. TRAUMA EMERGENCIES 4.1 Abdominal / P elvic Trauma 4.2 Bums / I nhalation Injuries 4.3 Head Trauma / I njury 4.4 Musculoskeletal Injuries 4.5 Multi-System Trauma 4.6 Soft Tissue / C rush Injuries 4.7 Spinal Column / C ord Injuries 4.8 Thoracic Trauma 4.9 Traumatic Cardiopulmonary Arrest 4. 1 0 Traumatic Amputations 5. PEDIATRIC EMERGENCIES 5.1 Newborn Resuscitation 5.2 Pediatric Anaphylaxis 5.3 Pediatric Bradydysrhythmias 5.4 Pediatric Bronchospasm / R espiratory Distress 5.5 Pediatric Cardiopulmonary Arrest 5.6 Pediatric Coma / A ltered Mental Status 5.7 Pediatric Seizures 5.8 Pediatric Shock 5.9 Pediatric Supraventricular Tachycardia 5.10 Pediatric Trauma & Traumatic Arrest 5.1 1 Pediatric Upper Airway Obstruction 5. 1 2 Pediatric Ventricular Fibrillation / P ulseless Ventricular Tachycardia Third Edition 11/1/00 APPENDICES A MEDICATIONS LIST B COMFORT CARE/DNR PROTOCOL C APGAR SCORE D OPTIONAL SKILLS / P ROCEDURES AED Needle Chest Decompression Needle Cricothyroidotomy Intraosseous Infusion NGT/OGT by paramedics in post-intubation patients E ENDOTRACHEAL TUBE SIZES F BURN CHART - P EDIATRIC & ADULT G TRAUMA SCORES H SPECIAL SKILL: Medication Assisted Intubation (MAI) by paramedics I J AIR AMBULANCE TRAUMA TRIAGE GUIDELINES K PROCESS FOR PROPOSING CHANGES TO TREATMENT PROTOCOLS AND INTRODUCTION OF NEW CONCEPT IMPLEMENTATION L MASS CASUALTY INCIDENTS / T RIAGE M PEDIATRIC VITAL SIGNS CHART N INTERFACILITY TRANSFER GUIDELINES BIBLIOGRAPHY Third Edition 11/1/00 Digitized by tine Internet Arcliive in 2015 https://archive.org/details/emergencynnedicalOOmass ACKNOWLEDGMENTS The Massachusetts Department of Public Health, Office of Emergency Medical Services gratefully acknowledges the efforts of many individuals and organizations in the development of this text. The most prominent contributions of time and effort have come from the five Regional Councils in the Commonwealth and their respective Medical Directors and Executive Directors. Many thanks to all of you and to those EMS physicians, Basic EMTs, Intermediate EMTs, and Paramedics around the Commonwealth who have greatly influenced the development process and the resultant Protocols Text. Louise Goyette John C. Benanti, M.D., FACEP Director Medical Director Special Recognition: Bruce Auerbach, M.D., FACEP Elliott Cohen, M.D., FACEP Robert Korn, M.D., FACEP Ray Conway, M.D., FACEP Gary Setnick, M.D., FACEP Tim LeBlanc, NREMT-P Paul Klainer, M.D., FACEP Kenneth Williams, M.D., FACEP Third Edition 11/1/00 ACKNOWLEDGMENTS Second Edition Page v