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The Designated NYS EMS Program Agency Serving Chemung,Schuyler & Steuben Counties
1058 West Church St. Elmira, NY 14905
Phone: 607-732-2354

2017 Protocols-pdf -click here Version 04 03 17 with corrections

CORRECTIONS
Please print and replace the pages listed below if you received or printed protocols prior to March 15, 2017.
Details:
Page 12: (1-3) Cardiac arrest: VF/V-tach
Page 15: (1-5) Obvious death
Page 17: (1-6) Termination
Latest  Corrections- April 3, 2017
Pages 83 and 84: Updates clarify that medical control is for cardioversion that is outside standing orders (there was confusion expressed by some that cardioversion appeared in both the standing order and medical control sections)
Page 112: Corrected dexamethasone concentration
Page 114: Corrected drip calculations (one for amiodarone and three for norepinephrine under the 15 gtt/ml admin set column)


 

Examination
The exam is “open book” and will not only be an assessment of knowledge but a practical exercise in extracting necessary information from the protocol document.
Open Exam
Open Blank Answer Sheet



Please use any or all of the following for your self-study review:

Collaborative topics

Topics covered by others in the collaborative include:

Simulation

The simulation videos are intended to demonstrate patient care scenarios in the context of the NYS collaborative protocols. Like the rest of medicine, there are different ways of practicing EMS and we encourage providers to watch the videos with a critical eye and think about how they would debrief the scenarios if they were the instructor/supervisor. Separate links for each module are listed so that you can chose which you would like to share with the providers in your region based on your needs. Special thanks to Laerdal for their assistance with these videos.

  • Intro
  • Double sequential defibrillation
  • Surgical cricothyroidotomy (Bougie assisted)
  • OB field delivery
  • Neonatal resuscitation
  • Informal debrief of neonatal resuscitation (critiques scenario and models informal call review)
  • Complications of delivery and normal delivery (including postpartum hemorrhage, shoulder dystocia, breech, etc.)
  • Avulsed tooth
  • Eye irrigation / Morgan Lens
  • PerfectCPR for Apple Watch
  • Massive bleeding (with hemostatic wound packing and clot removal)
  • Critical patient management with RSI
  • Formal debrief of critical patient management scenario (critiques scenario and models formal call review sessions)

NYS Collaborative Protocols Update Overview

Podcasts

The podcast are not all-encompassing but focus on particular points of interest. Providers often have questions about why certain things came out the way they did. In addition, there are some things that were discussed while we were writing the protocols that I think would be worth conveying to make sure the effect of the protocols results in the optimum patient care. The podcasts span two episodes and cover the topics below. The podcasts will eventually have a permanent YouTube home but you can use the links below to access the episodes for now.

Episode 38 (1 of 2):

Episode 39 (2 of 2):

 

For your reference, the discussion will include particular topics within the following protocols:

  • Page 5: Patient care responsibilities
  • Page 6: Medical control agreement
    • Regions will determine procedure for protocol deviations
  • (1-1): General cardiac arrest
    • Importance and maintenance of quality compressions
    • Transport safety issues
    • Waveform capnography
  • (1-3): V-fib arrest
    • Discuss the precipitate of CaCl2 and NaHCO3
    • Dilution of amiodarone bolus
  • (1-4): ROSC
    • Optimize patient condition prior to transport
  • (1-7): Pediatric arrest
    • No need to intubate if ventilating effectively
  • (2-2): Chest pain
    • Discussion of ASA, NTG, and 12-lead
  • (2-4): Agitated patient
    • Difference between agitated patient and excited delirium protocols
    • Titration of BDZ on standing order
  • (2-5): Oxygen
    • Concept of oxygen as a medication
    • Practice of using 15 LPM via NC during RSI
  • (2-6): Allergic reaction
    • Difference in indication for epi based on history of true anaphylaxis
    • Meaning of “consider” in protocol
  • (2-13): Chest trauma
    • Discuss sucking chest wound
    • Discuss CC in protocols
    • Review indications for chest decompression
  • (2-15): COPD
    • Discuss differences with statewide BLS protocols and what this means for the EMT
  • (2-19): Heat emergencies
    • Use of p.o. fluids
    • Discussion of water intoxication
  • (2-23): Hypoglycemia
    • Use of p.o. treatment
    • Discuss D10
  • (2-26): Musculoskeletal trauma
    • Pelvic fx management
  • (2-32): General pain management
    • Approximated weight based dosing
    • Ketamine effects
    • Ketorolac and nitrous cautions
    • Morphine histamine reaction vs true allergy
    • Rigid chest syndrome with fentanyl
  • (2-34): Post intubation management
    • Indicated for every intubated patient (not just for RSI providers)
    • Importance of analgesia (vs. sedation)
    • DOPE
  • (2-50): Vascular access
    • Lido for conscious IO
    • Limit unnecessary IVs in children
  • (4-9): Trauma criteria
    • Trauma center level destination based on CDC criteria

Self-Study

  • The above education does not cover every aspect of these protocols
  • Provider self-study is necessary to assure familiarity with the document and proficient navigation of the app