LINK TO TEST

There were a number of changes to the grammar and formatting of the protocols.

Those are important, I suggest you read through those and discover them for yourself.

LINK TO THE NEW PROTOCOLS

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Congratulations EMTS! You get two new (to here) medications!

Ibuprofen (PO) / Acetaminophen (PO)

Contain your excitement.

@thesaltyemt

… appreciated. #foryou #fyp #CapCut #emt #ems #emtlife #emslife #emthumor #emshumor #emtsoftiktok #emtstudent #viral #trending #croissantarmy🥐

♬ original sound – thesaltyemt

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Ibuprofen

Drug Class

• Nonsteroidal anti-inflammatory drug (NSAID)
• Non-opioid analgesic
• Antipyretic

Mechanism of Action

• Inhibits cyclooxygenase (COX-1 and COX-2) enzymes
• Decreases prostaglandin synthesis
• Reduces pain, inflammation, and fever
• Reversibly inhibits platelet aggregation (less than aspirin)

Contraindications / Precautions

• Known hypersensitivity/allergy to ibuprofen, aspirin, or other NSAIDs
• Active gastrointestinal bleeding or peptic ulcer disease
• Severe renal impairment
• Use during the third trimester of pregnancy
• Use with caution in older adults, dehydration, hypertension, cardiovascular disease, or patients taking anticoagulants (increased risk of bleeding)

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Acetaminophen

Drug Class

• Non-opioid analgesic
• Antipyretic

Mechanism of Action

• Acts centrally in the CNS
• Inhibits prostaglandin synthesis (COX pathway in brain)
• Lowers pain perception and reduces fever
• Minimal anti-inflammatory or platelet effect

Contraindications / Precautions

• Severe hepatic impairment or active liver disease
• Known hypersensitivity
• Chronic alcohol use (increased hepatotoxicity risk)
• Setting of shock or overdose (especially suspected Acetaminophen)

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Protocols and Dosing for both Ibuprofen and Acetaminophen

Pain Management – Adult / Fever – Adult

EMT

• If able to tolerate oral fluid, consider one of the following:
  • Acetaminophen up to 1000 mg
  • Ibuprofen up to 400 mg

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Pain Management – Pediatric / Fever – Pediatrics

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Changes to 12 lead language.

“Removed specific references to “Cardiac Monitor” or when to obtain a 12 -lead, as a cardiac monitor and 12-lead is to be used alongside other diagnostic equipment based on the patient’s needs and the certification and availability of such a device to the EMS clinician and need not be specified within any specific protocol except in limited circumstances.”

We still expect BLS 12 lead to be performed on all patients with chest pain, dyspnea, syncope, dizziness, fatigue, weakness, nausea, or vomiting. Use your best clinical judgement.

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IM Epinephrine in Pediatric Asthma / Wheezing

Mirrors the anaphylaxis protocol for dosing.

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Pre-Eclampsia and Eclampsia have their own protocol now:

• Pre-eclampsia and eclampsia should be considered in patients presenting after 20 weeks gestation and up to 6 weeks postpartum.

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Heat Emergencies

There is now a helpful description of active cooling, this is considered a time critical intervention;

• Begin active, whole-body cooling immediately until their mental status returns, at which time stop cooling efforts. Transport may be delayed if means of active cooling is available. Use any of the following in decreasing order of preference:
  • Ice water immersion, cold water immersion, or
  • Tarp-Assisted Cold water with Oscillation (TACO), or
  • cold water dousing, or
  • cold water-soaked towels with ice packs.

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New Protocol:

NYS has finally warmed up to the idea of Oxytocin (brand name Pitocin), a synthetic hormone used to induce or strengthen uterine contractions to control bleeding after childbirth.

That doesn’t affect you, however learning is fun.

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Tourniquet Conversion

Tourniquet conversion is the process of removing a tourniquet and replacing it with a hemostatic dressing or pressure bandage. The goal is to restore blood flow to the rest of the limb, preventing ischemic tissue damage.

• Tourniquet Conversion may be performed on a non-amputated extremity as follows:
  • Apply a pressure dressing to the wound
  • Slowly release the windlass and monitor for re-bleeding:
    • If re-bleeding occurs, re-tighten the tourniquet
    • If no bleeding occurs, release the tourniquet completely but leave in place
    • and monitor the dressing for re-bleeding until facility arrival

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TL;DR

https://www.health.ny.gov/professionals/ems/pdf/26-03.pdf

LINK TO TEST