EMS Protocol of the Week - Cold Emergencies

Happy COLD Tuesday!

Another guest post for the week where we will be discussing EMS protocol for Cold Emergencies that apply to both adult and pediatric populations.

The prehospital approach to cold emergency shows a nice progression of responsibilities based on level of training. CFRs at the most basic level will move the patient to a warmer environment, remove any wet clothing/jewelry, apply heat packs, and dry the patient with warm blankets. BLS crews will monitor for alter mental status, treat any hypoglycemia and request ALS backup. ALS providers on scene will perform advanced airway management as needed, begin cardiac monitoring and record an EKG for evaluation, and obtain IV access to administer warm crystalloid fluids if available.

Not a lot to do on the OLMC side other than to be aware of this stepwise progression, as well as understand localized cold injury vs generalized hypothermia (with possible loss of central pulses.)

Check out www.nycremsco.org or the protocol binder on North Side for more.

John Su

EMS Protocol of the Week - Decompression Sickness (Adult and Pediatric)

Weather's getting nicer, which makes it the perfect time for underwater adventures and the mayhem they may bring! The prehospital approach to decompression sickness mainly takes the form of recognizing the signs and symptoms and transporting to the closest hyperbaric center as appropriate (see the previously discussed list of specialty centers for reference). Don’t forget that companion divers should be transported in addition to the primary patient!

Anyone else a fan of these short emails? Plenty of info, without going…too deep? Hah!

www.nycremsco.org and the protocol binder, don’t forget!

Dave

EMS Protocol of the Week - Heat Emergencies (Adult and Pediatric)

Believe it or not, the weather is actually nice in Brooklyn sometimes. We hopefully seem to finally be finding ourselves leaving behind all the lousy cold, wet, depressing weather, which means we’ve got approximately 1-2 weeks before we find ourselves in lousy hot, sticky, depressing weather! Which makes now the best time to start reviewing the prehospital approach to heat emergencies, which in NYC generally amounts to exposure control (remove outser clothing) and fluid resuscitation (for ALS). Unfortunately, there isn’t enough room in an ambulance for a full ice bath, but that leaves something for you to do when the patient arrives to the ED! Just remember not to drop the temperature too quickly and to avoid shivering.

Stay cool out there, gang! Or warm, depending on how the weather is today when this email goes out.

www.nycremsco.org and the protocol binder for more!

Dave