EMS Protocol of the Week - Abdominal Pain / Severe Nausea / Severe Vomiting (Adult and Pediatric)

Belly problems? Have we got a protocol for you! 

Not a ton to this week’s protocol – patients in severe abdominal pain will be kept NPO at all EMS provider levels, and paramedics can give a dose of ondansetron by Standing Order as needed – with a reminder to check an EKG, both for QT prolongation and for possible cardiac etiologies of the abdominal pain. Remember that there is a separate pain management protocol available for patients requiring prehospital analgesia.

That’s it for this week, hope you were all able to…stomach it?

www.nycremsco.org and the protocol binder for more

Dave

EMS Protocol of the Week - Heat Emergencies (Adult and Pediatric)

Believe it or not, the weather is actually nice in Brooklyn sometimes. We hopefully seem to finally be finding ourselves leaving behind all the lousy cold, wet, depressing weather, which means we’ve got approximately 1-2 weeks before we find ourselves in lousy hot, sticky, depressing weather! Which makes now the best time to start reviewing the prehospital approach to heat emergencies, which in NYC generally amounts to exposure control (remove outser clothing) and fluid resuscitation (for ALS). Unfortunately, there isn’t enough room in an ambulance for a full ice bath, but that leaves something for you to do when the patient arrives to the ED! Just remember not to drop the temperature too quickly and to avoid shivering.

Stay cool out there, gang! Or warm, depending on how the weather is today when this email goes out.

www.nycremsco.org and the protocol binder for more!

Dave

EMS Protocol of the Week - Burns (Adult and Pediatric)

Prehospital burn management heavily focuses on exposure control by removing the source of burning and dressing wounds appropriately. Note the highlighted importance of removing any potentially constricting objects such as rings before edema develops. If ALS is on scene, they may initiate fluid resuscitation and manage pain, or they may call OLMC for guidance on either front. From there, it’s all about transport to the appropriate facility. The attached appendix lays out the criteria we use in NYC to determine whether patients should bypass closer hospitals to go to the nearest burn center.

See you all next week! www.nycremsco.org and the protocols binder for more!

Dave