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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