Drugs changes

Atropine is now recommended for slow PEA (<60 bpm). Also a ECG is required if possible prior to administration

Aspirin. Indications. 'Any conscious  patient Over 25' is  replaced by 'Any conscious adult patient

Contraindications Known allergy to Aspirin.not to be given to those on drugs such as warfarin

Administration To be chewed.

( this has changed so many times I think we might be sticking it up peoples Noses soon)

Pregnancy is now only a caution

Glucagon. a BM reading of 2mmols or below is required......is replaced by 4mmols. See drug protocol.

Nubain.Can now be given to children under 12 years. see drug protocols. shortly to be discontinued.

GTN can be administerd on estimated BP. see new protocol update.

Lignocaine.ECG strip required where possible. Also emphasis has been placed on making the decision to administer to patients based upon a palpable pulse rate greater than 140 bpm

New Drugs

New Drugs London Ambulance service. Nubain to be discontinued when present stocks are depleted. Tramadol is to be the replacement

metaclopramide. To be used as an anti-emetic,only in conjunction with Tramadol

Frusemide for use by paramedic staff in the treatment of patients suffering from Left Ventricular Failure. A Revision of ETO 8 will be issued to all frontline staff. Supplies are now available.

Qualification requirements for seconded staff

The CSC has approved the number of patient contact hours required for paramedic and technician staff who are seconded away from front-line duties, including operational officers.

 in order to maintain paramedic and technician qualification staff will be required to undertake 150 patient contact hours per year. These hours should be recorded and submitted on a yearly basis to their sector training officer.

Resuscitation / Life support

In Adult Basic life support the ratio of compressions to ventilations is now 15:2 irrespective of the number of rescuers.

Ventilation

Once the patients trachea has been intubated, chest compressions, at the rate of 100 per minute, should continue uninterrupted (except for difib, signs of life or pulse check where indicated) and ventilation continued at approx' 12 breaths per minute.

Difibrillation Child

AED. FR2

Over 8. Use adult pads

Under 8. Use Paediatric pads

Manual difib

First two shocks  2j/kg

Subsequent shocks 4j/kg

Difibrillation in Hypothermia.

Three shocks may be delivered as normal. Subsequent shocks should not be delivered until the patient has been re-warmed to above 30 degrees.

Patients with implanted defibs and pacemakers.

These patients can be treated with AED difib. Pads should be placed approx one pads distance from the device site.

External vein Cannulation

The clinical steering committee has approved the use of external jugular cannulation for adult patients who are in  non-trauma related cardiac arrest, as a last resort cannulation site.

This procedure may only be carried out by paramedics who have received specific training

Epeniphrine 1:1000 can now be administered by las technicians for those patients suffering from anaphylactic shock. If you have not received training please contact your team leader .