One of the nice things about the newly formatted protocols is that they start to eliminate some of the confusing redundancy with certain medications. A great example of this was for seizures. Under the old formatting, there was a dedicated seizure protocol, but there were also instances, like with the old head injury protocol, where the same seizure medications were described, often leading to inconsistencies if, say, dosages were inadvertently changed for one but not the other. Now, a sweeping change was made to the new protocols, placing topics like seizure management in a single space, with other protocols referring to that space as needed.
The new protocol for Head, Neck, and Spine injuries is one such example of this. Remember that, like with other trauma protocols, the focus is on good BLS care. In this case, that means ABCs, hemorrhage control, and C-spine stabilization with collar if indicated. ALS care covers advanced airway management and seizure control as needed, with reference to the specific seizure protocol for medication options. Stay tuned for a future email with updates specific to the seizure protocol, but broadly, you’re looking at Standing Order midazolam, lorazepam, or diazepam for adults, with repeat doses as Medical Control Options; or weight-based midazolam as SO for peds, with MCOs also allowing for weight-based lorazepam or diazepam.
Even though this new formatting may lead to you flipping between a couple different protocols, I think that overall, it helps streamline care in the field and eliminate opportunities for error. Disagree? Reach out! In the meantime, www.nycremsco.org or the protocols binder for more.
Dave