EMS Protocol of the Week - Neonatal Care/Resuscitation

So baby’s out, but the neonate is in trouble. It’s everyone’s worst nightmare, which is why the neonatal resuscitation protocol is there, giving clear-cut instructions for the most stressful of scenarios. Essentially, once recognizing the need for neonatal CPR, the protocol moves into standard life support algorithm instructions, with an emphasis on transport to a definitive care facility. Again, similarly to with last week’s protocol, I’ll refer to this one as a quick refresher, using it for target heart rates, respiratory rates, compression rates, and ventilation rates.

It’s a useful bit of cognitive offloading in the midst of what is otherwise emotionally overwhelming, to be sure. A protocol we hope to never have to use, but certainly one I’m grateful we have when needed.

And with that, believe it or not, we have completed the ENTIRETY of the NYC REMAC protocols!

Or at least, the current version.

SURPRISE! 

In the coming weeks, a BRAND NEW version will be hitting your inboxes as well as the streets! This new iteration has been in the works for an extraordinarily long time, and it’s bringing a LOT of overdue additions (spoilers: ketorolac!!!). Can’t wait to share it all with you, but if you’d like a jumpstart on all the new goodness, you can always head to www.nycremsco.org ! 

Dave

EMS Protocol of the Week - Emergency Childbirth

Baby’s on the way, everyone panic!

Procedures for imminent delivery can largely take place at the CFR level, with further instructions at the BLS and ALS levels for abnormal presentations, such as breech babies or prolapsed cords. Otherwise, this protocol does a great job at giving a stepwise approach to assisting mom and baby through the delivery process. Honestly, I often refer to it myself as a refresher of the process.

Hopefully, having this protocol as a reference helps the vast majority of EMS crews get through an uneventful delivery. But what if baby is not doing alright? We’ll cover that next week, in…

Wait for it…

Our FINAL protocol!

(sort of)

www.nycremsco.org or the protocol binder for a sneak peak.

 Dave

EMS Protocol of the Week - Obstetric Emergencies

The EMS protocol for obstetric emergencies basically goes down one of two paths – is baby coming out or not? If so, it’s all about positioning and referring to the protocol for emergency childbirth (stay tuned!) But if not, the focus shifts to hemorrhage/shock management and close monitoring with a high index of suspicion for maternal hypertension and pre-eclampsia/eclampsia. If an ALS unit is taking care of the patient, this is where they will call OLMC requesting to give IV magnesium, generally as a 2-4g IV infusion. But again, like with any other order, make sure you confirm dosing with clear, closed-loop communication!

The rest of the game is about transport, at this point. That is, right up until baby comes a’knockin! What do our crews do then? We’ll find out next week! Unless you’re all about those spoilers, in which case you’ve got www.nycremsco.org and the protocol binder for more.

Dave