EMT STANDING ORDERS:

• Routine Patient Care.
• Keep the patient in Trendelenburg's position.
• Prevent heat loss by covering with warm blankets if available and if the patient is not febrile.
• Check blood glucose level.
• Obtain 3 lead ECG if available.
• Establish IV access to KVO.
• Call for AEMT/Paramedic intercept. & Assisst AEMT/Paramedic in patient care.

AEMT / PARAMEDIC STANDING ORDER:

• Acquire and transmit 12-lead ECG.
• Identify and treat possible contributing factors.
• Consider 20ml/kg IV/IO boluses of isotonic crystalloid. Consider smaller boluses (e.g.,10 ml/kg if poor cardiac function is suspected).
• Consider the need for inotropic and/or vasopressor support for fluid-refractory shock.
  • Epinephrine 0.03 to 0.2 mcg/kg/min IV/IO.
  • Dopamine infusion 5-20 mcg/kg/min IV/IO to effect systolic > 70+(2xage).
  • Norepinephrine 0.03 to 0.5 mcg/kg/min IV/IO (if available).
• Consider Expert consultation as needed.