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2008 Protocol Revision Review
September 2008 Protocol Changes
Several important changes in our local protocols take effect 09/01/08. Here is a list and links to the protocol pages. Changes to protocol 31 and 7 are the biggest along with the additions to procedure #30; Hemorrhage Control.
Protocols:
#1 Airway Adult; continuous CO2 monitoring can be used in place of detector.
#2 Airway, Adult – Failed; “Combitube” changed to “BIAD”.
#7 IV Access; added IO access for adults.
#10 Universal Patient Care; Added hemorrhage control info.
#18 SVT; deleted A-fib/A-flutter reference.
#23 Allergic Reaction; Auto injectors now EMT level and higher.
#31 Pulmonary Edema; Deleted Morphine. Give Lasix if no improvement after NTG in setting of peripheral edema. Added capnography monitoring.
#44 Pediatric Multiple Trauma, #53 Extremity Trauma, #57 Multiple Trauma; added reference to Hemorrhage Control Procedure to all of these.
Procedures:
#2 Airway-Combitube; changed to “Airway – BIAD, Combitube”.
#3 Airway – BIAD King LT; this is a new procedure.
#5 Airway – End Tidal CO2 Monitoring; new procedure.
#6 Airway – Intubation Confirmation; Added continuous CO2 monitoring.
#8 Airway – Nebulizer; Added EMT level.
#15 Airway – Ventilator BI-Level/CPAP; reference to mfg’s guidelines added.
#23 Chest Decompression; added additional clinical indications.
#30 Hemorrhage Control; new procedure for tourniquets and hemostatic agents.
#47 Venous Access – Intraosseous IO: added adult IO and changed age range for manually inserted Cook needles.
Policies:
#17 DNR; includes the MOST form and name change to reflect others.
#15 Law Enforcement DWI Samples; added #6 to reflect changes in state law.
Appendix:
Age Reference Appendix; IO manual Cook needle now up to 8 years of age. 1 year and older AED, use ped pads for 1-8 years old.
Medications:
Lidocaine; IO pain control added.
Metoprolol; deleted.
NTG; administer every 5 minutes added.
Morhpine; no longer used for pulmonary edema.