OC Paramedic Protocols Questions With Complete
Solutions
Symptomatic Bradycardia Treatment Guidelines
1. Defined as ≤60bpm and one of the following:
Chest pain
Hypotension
ALOC
Skins
Shortness of breath
2. Implanted pacemaker with HR <60 treat the same
3. Cardiac pacing should not be delayed for IV/IO
4. BHC for hyperkalemia, calcium channel blockers, beta
blockers, digoxin
5. 12 lead interpretation for MI
6. BHC for push dose Epi
Narrow Complex Tachycardia Regular Rhythm SO
1. Monitor
2. Pulse Ox
3. HR 100-150 with hypovolemia (fluids)
4. HR ≥150
-Hypovolemia (fluids)
-Mild chest discomfort, lightheadedness, diaphoresis (valsalva,
adenosine)
-Cardiac chest discomfort, altered, BP<90 (cardiovert)
-ALS to ERC
,Narrow Complex Tachycardia Regular Rhythm Treatment
Guidelines
1. Applies to HR>100, regular, and QRS less than 0.12 sec
2. Don't give adenosine if wide complex
3. Unstable straight to cardioversion
4. Unstable may require unsynchronized if synch doesn't occur
5. HR 150 likely a-flutter
Narrow Complex Irregular Tachycardia SO
1. Monitor
2. Pulse Ox
3. 12 lead if chest discomfort or short of breath
4. Hypovolemia (Fluids 250ml Max)
5. ALS to ERC
Wide Complex Tachycardia with a pulse SO
1. Monitor
-If AICD fires twice within 15 minutes BHC for CVRC
2. Pulse Ox
3. Stable (BP>90, appropriate mental status, minimal chest
discomfort)
4. Unstable (BP≤90, altered, chest pain, signs of poor perfusion)
-Cardiovert
-Amio
-Cardiovert
-Amio
-Cardovert
5. ALS to ERC
, Wide Complex Tachycardia with a pulse Treatment Guidelines
1. May present with syncope, weakness, chest pain, shortness of
breath, light headedness
2. Don't treat if stable
3. Amiodarone slow to avoid drops in BP
Burns SO
1. Burn in enclosed space or heavy smoke (O2 by mask)
2. Apply cooling measures if burn is still symptomatic
3. Wheezing or suspected inhalation (Albuterol)
4. Pain if BP>90 (Morphine or Fentanyl)
5. BP≤90 (IV and Fluids)
6. ALS to Burn Center if Criteria is met
Burn Center Criteria
MOI:
-Suspected inhalation
-Electrical including lightning
-Chemical
Physiological:
-Burns to face, hands, feet, genitalia, or perineum
-Circumferential
-Pre-existing medical condition (diabetes, renal failure, cardiac,
or pulmonary)
TBSA:
-Second degree >10%
-Any third degree
Burn Treatment Guidelines
Solutions
Symptomatic Bradycardia Treatment Guidelines
1. Defined as ≤60bpm and one of the following:
Chest pain
Hypotension
ALOC
Skins
Shortness of breath
2. Implanted pacemaker with HR <60 treat the same
3. Cardiac pacing should not be delayed for IV/IO
4. BHC for hyperkalemia, calcium channel blockers, beta
blockers, digoxin
5. 12 lead interpretation for MI
6. BHC for push dose Epi
Narrow Complex Tachycardia Regular Rhythm SO
1. Monitor
2. Pulse Ox
3. HR 100-150 with hypovolemia (fluids)
4. HR ≥150
-Hypovolemia (fluids)
-Mild chest discomfort, lightheadedness, diaphoresis (valsalva,
adenosine)
-Cardiac chest discomfort, altered, BP<90 (cardiovert)
-ALS to ERC
,Narrow Complex Tachycardia Regular Rhythm Treatment
Guidelines
1. Applies to HR>100, regular, and QRS less than 0.12 sec
2. Don't give adenosine if wide complex
3. Unstable straight to cardioversion
4. Unstable may require unsynchronized if synch doesn't occur
5. HR 150 likely a-flutter
Narrow Complex Irregular Tachycardia SO
1. Monitor
2. Pulse Ox
3. 12 lead if chest discomfort or short of breath
4. Hypovolemia (Fluids 250ml Max)
5. ALS to ERC
Wide Complex Tachycardia with a pulse SO
1. Monitor
-If AICD fires twice within 15 minutes BHC for CVRC
2. Pulse Ox
3. Stable (BP>90, appropriate mental status, minimal chest
discomfort)
4. Unstable (BP≤90, altered, chest pain, signs of poor perfusion)
-Cardiovert
-Amio
-Cardiovert
-Amio
-Cardovert
5. ALS to ERC
, Wide Complex Tachycardia with a pulse Treatment Guidelines
1. May present with syncope, weakness, chest pain, shortness of
breath, light headedness
2. Don't treat if stable
3. Amiodarone slow to avoid drops in BP
Burns SO
1. Burn in enclosed space or heavy smoke (O2 by mask)
2. Apply cooling measures if burn is still symptomatic
3. Wheezing or suspected inhalation (Albuterol)
4. Pain if BP>90 (Morphine or Fentanyl)
5. BP≤90 (IV and Fluids)
6. ALS to Burn Center if Criteria is met
Burn Center Criteria
MOI:
-Suspected inhalation
-Electrical including lightning
-Chemical
Physiological:
-Burns to face, hands, feet, genitalia, or perineum
-Circumferential
-Pre-existing medical condition (diabetes, renal failure, cardiac,
or pulmonary)
TBSA:
-Second degree >10%
-Any third degree
Burn Treatment Guidelines
