Sharp ESO
Asystole - ANS - CPR (2 min)
O2 @ 15 L Ambu bag
Epi 1 mg IVP repeat q3-5 mins
repeat till ROSC
Bradycardia - ANS - O2 10L NRB if needed
Transvenous/Epicardial pacing if wires present , connect to pulse generator and initiate
pacing per protocol
Atropine 1 mg IVP q3-5 mins max 3 mg dose
Transcutaneous Pacing as soon as available
Dopamine IV infusion 5mcg/kg/min max 20
If ineffective, Epi IV infusion 2 mcg/min max 10
Cardioversion joules - ANS - 200
physician may order 75-120-150-200 for consitions not covered in ESO policy
Chest Pain - ANS - O2 4L NC
Nitro SL q3-5min max 3 doses
Morphine 2mg max 10 mg
Apirin 325 mg
If hypotension bolus 250
12 Lead EKG
Circumstance under which an ESO competent RN may perform ESO standarized
procedures - ANS - 1. Setting: code blue or Rapid Response Event
2. Scope of Supervision: absence of physician and in accordance of code status
3. Notify Physician
4. Med Availability
Comatose Adult - ANS - no eye opening to pain, no purposeful motor response
CPR - ANS - 30:2 compression-ventilation
100-120 beats per minute
1 breath every 6 seconds when advance airway in place
, complete chest recoil and minimize interruptions
Defibrillation Joules - ANS - 200
Documentation - ANS - unstable condition, precipitating factors, tx/med admin,
biphasic defib or joules, patient response to interventions and when/which physician
was notified.
Code blue record will be completed by RN and signed by physician then placed in chart;
acts as an order sheet
- completed for all cardiac and respiratory arrrest
End-tidal CO2 (ETCO2) - ANS - maximum CO2 concentration at the end of each tidal
breath. Reflects cardiac output during CPR.
ESO - ANS - pre-established medical orders, approved by appropriate medical staff to
be administered in the absence of a physician. these orders specify emergent treatment
interventions for life threatening conditions
General Procedure for all life threatening patient conditions - ANS - 1. IV/IO access
running NS to KVO
2. IV access unvailable doses are 2-2 1/2 times dose via endotracheal route
3.Flush meds with 20 NS
4. O2
Hypoglycemia - ANS - <70 in adults and <60 in pregnant adults
start hypoglycemia protocol
Hypotension: Symptomatic - ANS - O2 10L NRB if needed
250 Bolus repeat in 5 mins if no clinical improvement
SBP less than 90; Dopamine 5mcg/kg/min max 20 until SBP> 90 or MAP>60
Obvious blood loss: order H&H, type cross and 2PRBC
If sepsis follow protocol
PACU RN: Ephedrine 5mg IVP repreat in 3 min 10 mg IVP
Increased Intracranial Pressure - ANS - Neuro change suggesting increased ICP:
unilateral or bilateral fixed and dilated pupils, decorticate or deceberate posturing
Asystole - ANS - CPR (2 min)
O2 @ 15 L Ambu bag
Epi 1 mg IVP repeat q3-5 mins
repeat till ROSC
Bradycardia - ANS - O2 10L NRB if needed
Transvenous/Epicardial pacing if wires present , connect to pulse generator and initiate
pacing per protocol
Atropine 1 mg IVP q3-5 mins max 3 mg dose
Transcutaneous Pacing as soon as available
Dopamine IV infusion 5mcg/kg/min max 20
If ineffective, Epi IV infusion 2 mcg/min max 10
Cardioversion joules - ANS - 200
physician may order 75-120-150-200 for consitions not covered in ESO policy
Chest Pain - ANS - O2 4L NC
Nitro SL q3-5min max 3 doses
Morphine 2mg max 10 mg
Apirin 325 mg
If hypotension bolus 250
12 Lead EKG
Circumstance under which an ESO competent RN may perform ESO standarized
procedures - ANS - 1. Setting: code blue or Rapid Response Event
2. Scope of Supervision: absence of physician and in accordance of code status
3. Notify Physician
4. Med Availability
Comatose Adult - ANS - no eye opening to pain, no purposeful motor response
CPR - ANS - 30:2 compression-ventilation
100-120 beats per minute
1 breath every 6 seconds when advance airway in place
, complete chest recoil and minimize interruptions
Defibrillation Joules - ANS - 200
Documentation - ANS - unstable condition, precipitating factors, tx/med admin,
biphasic defib or joules, patient response to interventions and when/which physician
was notified.
Code blue record will be completed by RN and signed by physician then placed in chart;
acts as an order sheet
- completed for all cardiac and respiratory arrrest
End-tidal CO2 (ETCO2) - ANS - maximum CO2 concentration at the end of each tidal
breath. Reflects cardiac output during CPR.
ESO - ANS - pre-established medical orders, approved by appropriate medical staff to
be administered in the absence of a physician. these orders specify emergent treatment
interventions for life threatening conditions
General Procedure for all life threatening patient conditions - ANS - 1. IV/IO access
running NS to KVO
2. IV access unvailable doses are 2-2 1/2 times dose via endotracheal route
3.Flush meds with 20 NS
4. O2
Hypoglycemia - ANS - <70 in adults and <60 in pregnant adults
start hypoglycemia protocol
Hypotension: Symptomatic - ANS - O2 10L NRB if needed
250 Bolus repeat in 5 mins if no clinical improvement
SBP less than 90; Dopamine 5mcg/kg/min max 20 until SBP> 90 or MAP>60
Obvious blood loss: order H&H, type cross and 2PRBC
If sepsis follow protocol
PACU RN: Ephedrine 5mg IVP repreat in 3 min 10 mg IVP
Increased Intracranial Pressure - ANS - Neuro change suggesting increased ICP:
unilateral or bilateral fixed and dilated pupils, decorticate or deceberate posturing
