OBJECTIVESOBJECTIVES

Review new Vermont Statewide EMS Protocols What happens out

there On-line Medical

Direction Changes to your

practice

Stroke Systems Trauma Triage and

Destination STEMI Systems Burn Care Sepsis Alert Termination of

Resuscitation

Epinephrine by AEMT IO access by AEMT Naloxone by EMT CPAP by AEMT Advanced Spinal

Assessment

Critical Action Question:Last time without symptoms

• Rapid transport to correct facility based on regional transport agreements

• On scene time < 10 minutes• Rapid CT head, Neurology consult, ?

tPA

Trauma Triage and Transport Decision

Published: January 2012

Available for FREE at: www.cdc.gov/Fieldtriage

Physiologic Criteria

Anatomic Criteria

Mechanism of Injury Criteria

Special Considerations

Criteria Distance

EMTs can now obtain and transmit ECG

En-route:•Obtain 12 Lead ECG FIRST

• If automated read is “ACUTE MI,” call to activate STEMI. Transmit ECG en-route as soon as possible.

•Aspirin•IV Access•Nitroglycerin•Expedited Transfer to appropriate facility

Burn Updates

Fluid Administration in Burns - Adults

1240 patients ◦ Rule recommended termination for 776 patients◦ Of these, only 4 (0.5%) survived.◦ Positive predictive value for death of 99.5%.◦ Decrease rate of transportation from 100% to

37.4%

Administer Naloxone 2.0 mg Nasal via atomizer (1.0mg per nostril)