|
2006 Protocol Resources |
Protocols
Expires August 1, 2008 |
|
Get
Adobe Acrobat Reader
|
|
| CSEMS
Protocols Updated |
| Medical Control
Committee makes several changes at September
meeting |
|
At
the September meeting, the Medical Control Review
Committee moved to modify the Prehospital Standard
Patient Treatment Protocols as indicated in the
letter below. The Council was able to get the
updates to the printer before the field guides went
to press, therefore the field guides will not need
to be updated once they are printed and distributed
to regional agencies. |
|
The
complete protocol document, found exclusively on
this page, has been updated with the changes. |
Protocol Update Letter (9/24/08)
|
|
2008
Protocols
Updated 9/24/08 |
STEMI Triage
Protocols
 The
Medical Control Review Committee (MCRC)
recently announced some protocol
modifications and additions. Foremost, was a
new protocol that addresses ST-elevation
myocardial infarction (STEMI) triage in the
prehospital setting. The MCRC had been
working on these guidelines since January
2007.
In 2007,
Rockingham Memorial Hospital began staffing
a cardiac catheterization facility 24/7.
With catheterization facilities already
operating at the University of Virginia and
Roanoke Memorial Hospital, the committee
addressed the need to more appropriately
dispose patients in the region to facilities
best equipped to treat patients with STEMI.
Treatment of acute coronary syndrome (ACS),
particularly STEMI, is extremely
time-sensitive. Prehospital caretakers of
ACS patients can have a big impact on
patient outcome if they provide efficient
triage, stabilization, and referral for
cardiology care. Treatment of STEMI is
reperfusion through administration of fibrinolytics or percutaneous coronary
intervention (PCI).
The new protocol,
Protocol 4.27: ST-Elevation Myocardial Infarction
(STEMI) Triage, is designed to be used by
EMT-Intermediate and Paramedic level providers to
determine whether a patient presenting with STEMI
should be transported to the closest hospital or to
a hospital capable of cardiac catheterization.
The protocol is designed to be adaptable to allow
for appropriate patient disposition if new
catheterization services become available at other
hospitals in the region.
The protocol,
Protocol 4.4: Chest Pain (Non-Traumatic), has been
modified to take into account the new STEMI triage
guidelines. EMT-B and EMT-Enhanced level providers
that have a patient presenting with a STEMI are
prompted to consider ALS rendezvous, especially when
the 12-lead indicates the patient is experiencing an
acute myocardial infarction. EMT-B and EMT-Enhanced
providers are also prompted to consider air medical
support if the transport time to the cardiac
catheterization facility is greater than 60 minutes
for STEMI patients. EMT-Intermediate and Paramedic
providers are directed to follow the STEMI triage
guidelines.
All agencies are
encouraged to review these guidelines with their
operational medical director and develop
intradepartmental policies and procedures that
relate to these new guidelines. For example,
agencies should have procedures that outline the
steps in acquiring and transmitting a 12-lead ECG to
any facility to which they may transport a patient.
As another example, agencies need to ensure
personnel are familiar with the alternate facility
locations and communication procedures with those
facilities.
Coinciding with the
introduction of the STEMI triage guidelines, the
procedure guideline Protocol 5.1: 12 Lead ECG
Acquisition was expanded to include some extra
helpful tips and precautions.
Earlier this year,
the committee moved to remove use of intraosseous
devices such as the Jamshidi and the F.A.S.T.1,
recognizing the EZ-IO as the IO device of choice.
Those sections in the protocols have been struck.
The CSEMS Council is
available as a resource to help as agencies adopt
these new guidelines. If you have any questions or
concerns, please contact your OMD or the Council.
The new guidelines will be effective January 1,
2008.
EZ-IOs Distributed to
Region
 The
Central Shenandoah EMS Council sponsored two
training sessions conducted by Vidacare and
Sovereign Medical on February 26 and 27.
During this training, representatives from
regional agencies were trained on the use of the
EZ-IO and will now train other providers at
regional agencies. Presently, Cardiac
Tech, EMT-Intermediate and Paramedic level
providers are those that are authorized to use
the device. A misprint in the original
version of the protocols errantly indicated
Shock Trauma Technicians could perform the
skill.
The CSEMS Council
has training devices available to be checked out
for training at regional agencies. These
devices include driver sets and various bones
for practice. To check out the EZ-IO
training devices, complete the form on the
Equipment Reservation page.
The CSEMS Council
will facilitate an exchange of F.A.S.T.1 IO
devices for EZ-IO needles. This exchange
will be on a one-for-one basis. Agencies
should submit the F.A.S.T.1 devices to the
Council no later than April 15, 2007.
Sovereign Medical, LLC is the distributor of
the EZ-IO. Agencies should contact the
regional representative,
Mack Overman, to order additional driver
sets, replacement needles or other accessories. Advanced Life
Support agencies that have not received the
EZ-IO kits should contact
Matt Lawler at the CSEMS Council.
Vidacare EZ-IO Product System
Sovereign Medical, LLC
EZ-IO On-Line Training & Other Training
Documents
|
