"Protocol Update Table Edited2011"
Changes to Statewide Treatment Protocols* Effective date March 1, 2011 (Services whose EMTs are trained and equipped may begin to follow January 20, 2011) Protocol Section Change All Remove endotracheal tube as a medication route; add interosseous (IO) access as required equipment for paramedic services General Principles Update and strengthen provision regarding EMT-Paramedics’ ability to acquire and interpret 12-lead ECGs, to require ambulance services, working with their affiliate hospital medical directors, to ensure the competency of all their EMT- Paramedics in 12-lead ECG acquisition and interpretation as a condition of authorization to practice, at least every two years. Cardiac Emergencies Emphasize modern cardiopulmonary resuscitation (CPR) as per 2010 guidelines for CPR and Emergency Cardiac Care (ECC) of the American Heart Association (AHA) 1.1 Asytole Remove atropine; add vasopressin as optional medication 1.5 Acute Coronary Remove morphine and beta-blocker Syndrome (ACS) 1.6 Post-resuscitation 1. Move lidocaine to medical control (MC) option care 2. Move amiodarone to standing orders 3. Add recommendation to check for ST-elevation myocardial infarction (STEMI), then use STEMI point of entry 4. Clarify Post-Arrest Induced Hypothermia (PAIH) Guidelines and Standing Orders 1.7 Premature Move lidocaine to MC option Ventricular Complexes (PVC) 1.8 Pulseless Electrical Move atropine to MC option Activity 1.10 Ventricular Move lidocaine to MC option; add vasopressin as optional medication Fibrillation (VF)/ Pulseless Ventricular Tachycardia (VT) 1.11 VT with pulses 1. Move lidocaine to MC option 2. Add adenosine as medical control option for selected “VT” only 3.4 Bronchospasm/ Add continuous positive airway pressure (CPAP) as standing order with Respiratory Distress bronchodilator therapy, and add indications/contraindications 3.5 Congestive Heart 1. Remove morphine Failure (CHF) 2. Remove fentanyl 3. Move furosemide to MC options 4. Add CPAP indications/contraindications. 5.11 Pediatric Upper Change epinephrine to “racemic” at dose 11.25 mg Airway Obstruction 5.12 Pediatric VF Remove lidocaine Appendix A: Medication 1. Change amiodarone to required List 2. Add racemic epi to required 3. Add vasopressin as optional 4. Change fentanyl to required Appendix N: ALS Incorporate protocols for specific types of interfacility transfer calls, including Interfacility Transfer what was previously labeled Appendix N-1 Guidelines *Updated on 2/1/11 by CMEMSC to include change to Protocol 1.8 PEA