EMT STANDING ORDERS:

• Routine Patient Care.
• Optimize ventilation and oxygenation:
  • Administer oxygen as appropriate with a target of achieving 92% - 98% saturation.
  • Consider advance airway LMA when it's indicated.
• Maintain the patient's body temperature.
• Call for AEMT/Paramedic intercept. & Assisst AEMT/Paramedic in patient care.

AEMT / PARAMEDIC STANDING ORDER:

• Optimize ventilation and oxygenation:
  • Consider advanced airway when its indicated and use waveform capnography to confirm and monitor the correct placement of the ET tube.
  • Titrate ventilation rate to waveform capnography of 35 to 40 mmHg.
• 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.
  • For hypotensive shock:
    • Epinephrine 0.03 to 0.2 mcg/kg/min IV/IO infusion.
    • Norepinephrine 0.03 to 0.5 mcg/kg/min IV/IO infusion.
  • For normotensive shock:
    • Epinephrine IV/IO route 0.03 - 0.05 mcg/kg/min infusion.
    • Milrinone IV/IO route 50 mcg/kg over 10 to 60 minutes infusion.
• Check patient follows commands and maintains Targeted Temperature Management TTM, including aggressive treatment of fever.
• Monitor for and treat agitation and seizures (as per protocol).
• Consider for expert consultation.