ValleyProtocolBook

The Valley Hospital Emergency Services

8

Standing Orders / Communications Failure Orders

(h) Post intubation, continuous waveform capnography shall be monitored for the duration of the patient encounter.

(i) If the patient requires sedation due to bucking or combative behavior, the ALS crewmembers shall administer Lorazepam 0.1 mg/kg to a maximum dose of 2 mg IV/IO push as long as the systolic blood pressure is at least 90 mmHg. This may be repeated one time in 15 minutes if the patient requires additional sedation.

8.41-8.6 Standing orders for pediatric vascular access

(a) The following standing orders for the initiation of pediatric vascular access are authorized in those cases where an emergent or potentially emergent condition exists and current ALS treatment protocols require the initiation of IV therapy. In such cases, ALS crewmembers may establish vascular access at keep vein open (KVO) rate, establish vascular access with a saline port, or establish intraosseous infusion prior to contacting medical command. a. ALS crewmembers shall contact medical command as soon as possible after the establishment of vascular access. Contact with medical command shall not be delayed by, or as a result of, unsuccessful vascular access in the field.

b. The time of the initiation of vascular access and the time of contact with medical command shall be recorded on the patient care report.

c. The provider's medical director shall notify the Department as to the solution to be utilized for vascular access when established under this section.

(b) This standing order may be utilized in conjunction with any other standing order where vascular access is indicated.

Communications Failure Orders for pediatric vascular access:

(a) Do not delay transport in the event of a patient with difficult vascular access.

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