Podcast
Questions and Answers
What must be done before initiating blood products during interfacility transport?
What must be done before initiating blood products during interfacility transport?
- Administer at least 100 mL prior to departure
- Confirm with a registered nurse or physician (correct)
- Ensure no allergies are present
- Start the infusion at the receiving facility
What should be considered if a patient's transport needs exceed the capabilities of the ALS interfacility unit?
What should be considered if a patient's transport needs exceed the capabilities of the ALS interfacility unit?
- Transport the patient without additional resources
- Reassess the patient's condition before transport
- Consider the need for additional specialty transport resources (correct)
- Delay transport until capabilities are met
What was removed from the protocol regarding blood infusions before transport?
What was removed from the protocol regarding blood infusions before transport?
- The need to start the infusion for at least 15 minutes (correct)
- The verification of blood units by hospital staff
- The restriction on blood product types that can be transported
- The requirement for documentation of patient allergy
What does the new addition titled 'Shock Index' include?
What does the new addition titled 'Shock Index' include?
Where was the allergy reference moved in the updated protocol?
Where was the allergy reference moved in the updated protocol?
What is the new upper limit for systolic blood pressure in the ALS to BLS release?
What is the new upper limit for systolic blood pressure in the ALS to BLS release?
In pediatric seizures, what is the maximum dose of midazolam to be administered?
In pediatric seizures, what is the maximum dose of midazolam to be administered?
What should be done if signs of fluid overload develop in pediatric shock?
What should be done if signs of fluid overload develop in pediatric shock?
What is the revised maximum dose for Epinephrine in pediatric allergic reactions?
What is the revised maximum dose for Epinephrine in pediatric allergic reactions?
Which of the following is a new guideline for pediatric bradycardia?
Which of the following is a new guideline for pediatric bradycardia?
What is the updated intercostal space for needle decompression in pediatric patients?
What is the updated intercostal space for needle decompression in pediatric patients?
What action was removed regarding pediatric CPR in patients with cardiac arrest from submersion injury?
What action was removed regarding pediatric CPR in patients with cardiac arrest from submersion injury?
In the updated guidelines, what term is now used regarding optional junctional tourniquet?
In the updated guidelines, what term is now used regarding optional junctional tourniquet?
What is the updated maximum dose for Norepinephrine during post-resuscitation care?
What is the updated maximum dose for Norepinephrine during post-resuscitation care?
Which medication has had its dosing guidelines changed for pediatric patients?
Which medication has had its dosing guidelines changed for pediatric patients?
What is the range for the Tylenol PO dose according to the new protocol?
What is the range for the Tylenol PO dose according to the new protocol?
In the updated protocol, which condition was moved from an absolute contraindication to a relative contraindication for airway management?
In the updated protocol, which condition was moved from an absolute contraindication to a relative contraindication for airway management?
What was the change made to the dose of Toradol for adult patients?
What was the change made to the dose of Toradol for adult patients?
Which of the following changes was made regarding pediatric and adult airway management?
Which of the following changes was made regarding pediatric and adult airway management?
What modification was made regarding Benadryl administration for patient restraint?
What modification was made regarding Benadryl administration for patient restraint?
What significant change was added concerning mandatory ALS equipment?
What significant change was added concerning mandatory ALS equipment?
What was the change made to the fluid bolus for Sepsis in 2024?
What was the change made to the fluid bolus for Sepsis in 2024?
What is the updated upper range for Norepinephrine administration after 2024?
What is the updated upper range for Norepinephrine administration after 2024?
In the management of Acute Coronary Syndromes, what was the new systolic blood pressure limit set in 2024?
In the management of Acute Coronary Syndromes, what was the new systolic blood pressure limit set in 2024?
What was the significant change in the treatment of Hemodynamically Compromising Bradycardia?
What was the significant change in the treatment of Hemodynamically Compromising Bradycardia?
What was added to the General Adult Cardiac Arrest Bundle of Care in 2024?
What was added to the General Adult Cardiac Arrest Bundle of Care in 2024?
What significant change was made regarding the duration of resuscitative efforts?
What significant change was made regarding the duration of resuscitative efforts?
What is the new terminology introduced for CPAP/BiPAP in the document?
What is the new terminology introduced for CPAP/BiPAP in the document?
What age was specified for patients in the newly titled 'Pediatric and Adult Traumatic Cardiac Arrest' protocol?
What age was specified for patients in the newly titled 'Pediatric and Adult Traumatic Cardiac Arrest' protocol?
What new guideline was added for pediatric patients regarding needle decompression?
What new guideline was added for pediatric patients regarding needle decompression?
What was the change made to the dose of Epinephrine?
What was the change made to the dose of Epinephrine?
Which medication's dose was clarified to a maximum of 24 mg?
Which medication's dose was clarified to a maximum of 24 mg?
What is the new protocol added for Non-Invasive Mechanical Ventilation?
What is the new protocol added for Non-Invasive Mechanical Ventilation?
What change was made regarding the Midazolam dosage?
What change was made regarding the Midazolam dosage?
What additional consideration was added under the Opioid Overdose section?
What additional consideration was added under the Opioid Overdose section?
In the management of Pulmonary Edema due to Congestive Heart Failure, what was added?
In the management of Pulmonary Edema due to Congestive Heart Failure, what was added?
What dose change was made to Droperidol for nausea/vomiting refractory to Zofran?
What dose change was made to Droperidol for nausea/vomiting refractory to Zofran?
Flashcards
NIMV
NIMV
Non-Invasive Mechanical Ventilation for CPAP/BiPAP treatments
BiPAP Dosage
BiPAP Dosage
BiPAP is now optional; details on its use in various cases, like Pulmonary Edema, are included.
Epinephrine Dosages, change of
Epinephrine Dosages, change of
Epinephrine's dosage now listed as 0.5 mg. Dosage changes impact procedures.
Midazolam IM/IV dose change
Midazolam IM/IV dose change
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Nitroglycerin change, dosage of
Nitroglycerin change, dosage of
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Buprenorphine Protocol
Buprenorphine Protocol
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Norepinephrine change, dosage of.
Norepinephrine change, dosage of.
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Benadryl dosage change
Benadryl dosage change
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ALS to BLS Release
ALS to BLS Release
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Pediatric Seizure Treatment
Pediatric Seizure Treatment
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Pediatric Shock Treatment
Pediatric Shock Treatment
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Pediatric Allergic Reaction
Pediatric Allergic Reaction
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Pediatric Bradycardia
Pediatric Bradycardia
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Pediatric Tachycardia
Pediatric Tachycardia
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Pediatric CPR Changes
Pediatric CPR Changes
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Pediatric and Adult Trauma
Pediatric and Adult Trauma
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Sepsis Standing Order Change
Sepsis Standing Order Change
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ACS Systolic BP
ACS Systolic BP
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STEMI Systolic BP
STEMI Systolic BP
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Hemodynamically Compromising Bradycardia
Hemodynamically Compromising Bradycardia
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Cardiac Arrest Ketamine
Cardiac Arrest Ketamine
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Traumatic Cardiac Arrest Change
Traumatic Cardiac Arrest Change
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Termination of Resuscitative Efforts
Termination of Resuscitative Efforts
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Asystole/PEA Norepinephrine
Asystole/PEA Norepinephrine
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Adult Blood Admin. Protocol
Adult Blood Admin. Protocol
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Pediatric Blood Admin. Protocol
Pediatric Blood Admin. Protocol
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Post-Resuscitation Temp. Mgmt.
Post-Resuscitation Temp. Mgmt.
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Patient Restraint Protocol
Patient Restraint Protocol
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Airway Management Protocol
Airway Management Protocol
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Pain Management Changes
Pain Management Changes
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ALS Equipment Inventory
ALS Equipment Inventory
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Medication List Update
Medication List Update
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IV Infusion Transport
IV Infusion Transport
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Blood Product Initiation
Blood Product Initiation
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Shock Index
Shock Index
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Hospital Contacts
Hospital Contacts
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Allergy Protocol Changes
Allergy Protocol Changes
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Study Notes
Standing Orders - 2024 Changes
- Non-Invasive Mechanical Ventilation (NIMV): BiPAP added after CPAP, moving ALS Priority I to be before II and III. Removed (Pilot) and changed to (Optional).
- Opioid Overdose: Added tiered dosing (0.4 mg per dose) and authorized total ALS dose of up to 6 mg. Total ALS doses for Buprenophine are authorized for all agencies.
- Midazolam: Increased IM dose to 10 mg and IV dose to 5 mg, with a total of 3 doses allowed. Clearer wording for magnesium sulfate administration.
- Epinephrine: Increased dose to 0.5 mg IM. Removed dose range for Benadryl, now 50 mg.
- Norepinephrine: Increased dose from 10-40 mcg/min to 10-50 mcg/min, titrating by 10 mcg every 5 minutes to maintain MAP greater than 65.
- Other Changes: Protocol reformatted, and language extended for multiple items in the updated standing orders.
Sepsis
- POC Lactate Meters: Removed.
- Fluid Bolus: Changed from 30 ml/kg to 1000 ml. After 1000 ml bolus add Norepinephrine.
- Norepinephrine: Increased upper range to 50 mcg/min.
- Systolic BP: Decreased from less than 150 to less than 120.
Acute Coronary Syndromes (ACS)
- Systolic BP: Decreased from less than 150 to less than 120.
Hemodynamically Compromising Bradycardia
- Atropine: Increased from 0.5 mg to 1mg.
- Ketamine: Added 0.25mg/kg for pain from pacing.
General Adult Cardiac Arrest Bundle of Care
- Ketamine: Added for neurologic responsiveness and/or consciousness.
Traumatic Cardiac Arrest
- Resuscitative Efforts: Changed from 30 to no less than 20 minutes.
Termination of Resuscitative Efforts & Telemetric Pronouncement of Death
- Resuscitative Efforts: Changed from 30 to no less than 20 minutes.
Pediatric and Adult Pain Management
- Tylenol (Acetaminophen): PO dose changed from 1000 mg to 975-1000 mg.
- Pediatric Dose of Tylenol: 15 mg/kg to adult maximum dose.
- Toradol: Dose changed to 15 mg for all adult doses.
- Fentanyl: Changed adult max dose to 400 mcg.
- Pregnancy: Added as a contraindication for Toradol.
Other Updated Standing Orders
- Interfacility Management of Previously Initiated Continuous IV Fusions: Clarified language on ALS interfacility transport needs, if capacity exceeded.
- Blood Products (Interfacility): Removed "Blood infusions must be started at the sending facility for at least 15 minutes and at least 50 mL must be infused before transport can begin," and wording changed to require verification by nurse/physician. -Paramedics confirming with a nurse or physician before initiating blood product transport.
- Mandatory ALS Equipment Inventory: Added ET tubes and Droperidol to the list.
- Protocol Reformatting: Protocol formatting changed for several items such as medications and dosing protocol.
- Protocols: Protocols were reformatted and updated in several categories.
Pediatric Standing Orders
- Pediatric Shock and Hypotension: Discontinue fluid bolus if fluid overload develops.
- Pediatric Tachycardia: Changed maximum atropine dose to 1 mg.
- Pediatric CPR: Removed redundant bullet point.
- Pediatric and Adult Trauma, Adult Blood Administration, Pediatric Blood Administration: Added guidelines and/or wording changes.
- Patient Restraints: Additional information added for specific pediatric and adult procedures.
- Airway Management: Added language about hemodynamic resuscitation.
- Extreme Agitation: Atropine dose changed to 0.5 mg IV and Midazolam dose to 5 mg IM. Additional protocol notes included as well.
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Description
This quiz covers the recent changes to standing orders in 2024, focusing on updates regarding Non-Invasive Mechanical Ventilation, opioid dosing, and protocol adjustments for emergency care. Test your knowledge on the new guidelines regarding dosing and treatment protocols.
