EMT STANDING ORDERS:

• Routine patient Care.
• Place patient in a comfortable Position.
• Connect to cardiac monitors, attach pulse oximetry and BP cuff.
• Focused assessment to include:
  • Urine output/number of diapers used
  • Vomiting/diarrhea
  • Skin color (core vs. periphery) and temperature
  • Lack of tears
  • Mental status
  • Heart rate
• Prevent heat loss.
• Place patient supine position.
• Use caution with patients in respiratory distress.
• Consider expert consultation.

AEMT/PARAMEDIC STANDING ORDERS

• Routine patient Care.
• If patient is Hypotensive, Systolic BP < 70+(2x age)
• administer fluid bolus 20 ml/kg of normal saline IV/IO, repeat as needed up to 3 times to effect SBP> 70+ 2xage.
• Administer fluid challenge Normal Saline.
• Neonates: 10 ml/kg IV over 10 minutes If refractory, repeat once.
• Reassess lungs and vitals after each bolus.
• Carefully monitor for fluid overload.
• Infants to children: 20 ml/kg IV rapid. If refractory, repeat up to
• two times. Reassess lungs and vitals after each bolus.
• Carefully monitor for fluid overload.
  • Consider Dopamine Infusion 5-20mcg/kg/min IV/IO to effect SBP> 70+ (2x age).
  • Continue airway assessment and consider Advance
• Airway management if indicated as (per the intubation protocol).