2015 Trumbull Memorial Hospital Demo

Respiratory Distress Respiratory Distress

Universal Patient Assessment

Oxygen Titrate SpO2 to 94%

Adult Airway Protocol

Cardiac Monitor 12-Lead ECG If EMT or STEMI, transmit

Adult IV/IO

Position of Comfort

Consider CPAP 5 cmH2O Watch for air trapping

Known Asthmatic / COPD Exacerbation / Wheezes

Crackles and CHF Signs with CHF History

Suspected Pneumonia / Unknown / Other

Consider CPAP 10 cmH2O

Support Symptoms

Consider DuoNeb EMT Call-In Order

If hypertensive Nitro Paste 1” Or Nitro Tab 0.4mg SL Repeat tab every 5 minutes. Maintain SBP >100 EMTs may call-in for this order.

Consider Solu-Medrol 125mg IV/IO/IM

Clinical Considerations If etiology of respiratory distress is unknown:  Oxygenate  Attempt CPAP  Support symptoms  Avoid overmedication, as some meds that are good for COPD are bad for CHF and vice versa.

Consider Adult Epi-Pen 1 dose EMT Call-In Order if treating asthma with epi-pen

Clinical Considerations AEMTs and Paramedics  Consider using 0.3mL (0.3mg) of Epinephrine 1:1,000 IM in place of epi- pen if needed.

Known asthmatics, consider

Magnesium Sulfate 2g IV/IO over 10 minutes

50

EMR

EMT

AEMT

Paramedic

Extended