ADULT PROTOCOLS .com
Wake County EMS System
ADULT PROTOCOLS
Cardiac Arrest
History: y Events leading to arrest y Estimated downtime y Past medical history y Medications y Existence of terminal i llness y Signs of lividity, rigo r mortis y DNR
Signs and Symptoms: y Unresponsive y Apneic y Pulseless
Differential: y Medical vs Trauma y V. fib vs Pulseless V. tach y Asystole y Pulseless electrical activity (PEA)
Withhold resuscitation
Universal Patient Care Protocol
Yes
Criteria for Death / No Resuscitation
No
Begin Continuous Compressions
ALS Available?
No
Yes
Legend
EMT
I EMT- I I
P EMT- P P
M MC Order M
AT ANY TIME Return of
Spontaneous Circulation Go to
Post Resuscitation Protocol
Automated Defibrillation Procedure
I
Assess Rhythm
I
Airway Procedure
Interrupt Compressions Only as per AED Procedure. Ventilate no more than 12 breaths per minute (1 breath eve ry 5 seconds)
Go to appropriate p rotocol:
Ventricular Fibrillation Pulseless Ventricular Tachycardia
Pulseless Electrical Activity Asystole
Pediatric Pulseless Arrest
Pearls: y Exam: Mental Status y Success is based on proper planning and execution. Procedures require space and patient access. Make room to
work. y If witnessed arrest - administer a precordial thump. y Reassess airway frequently and with every patient move. y Maternal Arrest - Treat mother per appropriate protocol with immediate notification to Medical Control and rapid
transport. y Adequate compressions with timely defibrillation are the keys to success.
Version 1.1
Wake County EMS System Protocols
CA-1
Ventricular Fibrillation
Pulseless Vent. Tachycardia
History: y Estimated down time y Past medical history y Medications y Events leading to arrest y Renal failure / dialysis y DNR
Signs and Symptoms: y Unresponsive, apneic, pul seless y Ventricular fibri llation or ventricular
tachycardia on ECG
Differential: y Asystole y Artifact / Device failure y Cardiac y Endocrine / Metabolic y Drugs y Pulmonary
Cardiac Arrest Protocol
Defibrillation Sequence: Defibrillate @ 360 J
Immediately Resume CPR Reassess Rhythm and Repeat q 2 mins
Legend EMT
I EMT- I I
Airway Protocol Begin Ventilations ................
................
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