EMS Protocol of the Week - Head, Neck, and Spine Injuries (Adult and Pediatric)

Surprise, another trauma protocol that focuses on ABCs and BLS-level care!

Of course, any paramedics that happen upon a trauma job that requires airway control or vascular access is expected to do so, but the bulk of the protocol on head/neck/spine injuries boils down to how EMTs can best support these patients for transport. The big takeaway is familiarizing yourself with the criteria crews will use in determining spinal precautions, c-spine stabilization, and rigid collar application. As you can see, the criteria mostly line up with those that we would use in the ED, with “any other provider concern…” adding some extra wiggle room to allow for provider gestalt. Keep that in mind as you receive these patients, as they may be eligible for c-collar clearance after an initial evaluation, rather than several CTs and an MRI later.

Let’s hear it for protocols! And for our EMTs and paramedics, who put their…necks out?...on a daily basis? Anyone? Bueller?

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

 Dave

EMS Protocol of the Week - Decompression Sickness (Adult and Pediatric)

Weather's getting nicer, which makes it the perfect time for underwater adventures and the mayhem they may bring! The prehospital approach to decompression sickness mainly takes the form of recognizing the signs and symptoms and transporting to the closest hyperbaric center as appropriate (see the previously discussed list of specialty centers for reference). Don’t forget that companion divers should be transported in addition to the primary patient!

Anyone else a fan of these short emails? Plenty of info, without going…too deep? Hah!

www.nycremsco.org and the protocol binder, don’t forget!

Dave

EMS Protocol of the Week - Altered Mental Status (Adult and Pediatric)

Another protocol to have been affected by 2022 reformatting, the prehospital approach to AMS primarily addresses hypoglycemia at this point. Naloxone dosing, which was previously found under this protocol, is now under the Overdose protocol reviewed earlier in the year.

EMS must obviously be mindful of other etiologies of AMS (toxicologic, traumatic, behavioral, etc.) and manage appropriately, both in terms of patient care and overall scene safety. For patients with a change in mental status due to hypoglycemia, this protocol goes over a number of considerations for oral and parenteral management based on level of training and patient condition, all of which are worth reviewing.

Replete the sugar, is what it comes down to. Once again – short…and sweet? On a roll, here.

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

Dave