APPENDICES

EFFECTIVE:  March 1, 2000

APPENDIX A

ALS PROCEDURES, EQUIPMENT AND DRUG LISTS

HENNEPIN COUNTY EMS SYSTEM

 

 

ALS PROCEDURES

                                                                                      

Required ALS Procedures

 

·        ·         All BLS procedures (including oral and nasal airway insertion and MAST application)

·        ·         ECG monitoring/interpretation

·        ·         Defibrillation

·        ·         Synchronized cardioversion

·        ·         Deactivation of implantable cardiac defibrillators (ICD)

·        ·         EOA or ETC (Combitube) insertion

·        ·         Direct laryngoscopy for foreign body removal using Magill forceps

·        ·         Endotracheal suctioning

·        ·         Peripheral IV insertion (including external jugular)

·        ·         Blood drawing

·        ·         Administration of specified drugs by:         IV push technique

                                                                  IM and SC injection

                                                                  sublingual injection

                                                                  oral and sublingual administration

                                                                  inhalation (includes nebulization)

·        ·         Needle thoracostomy for tension pneumothorax

·        ·         Direction of patient in Valsalva maneuver

·        ·         Blood glucose measurement

·        ·         Uterine massage

 

 

Permitted ALS Procedures

 

·        ·         Transcutaneous pacing        

·        ·         Endotracheal intubation

·        ·         Administration of specified drugs via endotracheal tube

·        ·         Nitronox administration

·        ·         Intraosseous infusion of IV fluids and drugs for pediatric patients

·        ·         Measurement of peak expiratory flow rate

·        ·         Cricothyrotomy

·        ·         Percutaneous transtracheal ventilation

·        ·         Measurement of end tidal CO2

·        ·         Measurement of O2 saturation by pulse oximetry

 

 

Unapproved ALS Procedures

 

·        ·         Carotid massage

·        ·         Tracheotomy

·        ·         Intracardiac injection

·        ·         Pericardiocentesis

·        ·         Central IV line insertion

·        ·         Initiation of IV drip medications

·        ·         Nasogastric tube insertion

 

                                                                                    A-1

                                                     ALS EQUIPMENT - ADULTS

 

                                                                                      

 

The following "Required" equipment must be carried on all Hennepin County ALS ambulances and includes ALS equipment mandated by State rules and regulations:

 

Required Adult ALS Equipment                                                                                   Options

 

·        ·         Lower extremity traction splint..................................................... Hare or Ferno

·        ·         Immobilization devices for upper and lower extremities................. choice of brands

·        ·         Active Aid short and long backboards and accessories................. Bird and Cronin

·        ·         Cervical immobilization device...................................................... choice of brands

·        ·         Portable oxygen system with liter flow device and

              manually cycled PP valve............................................................ choice of brands that meet State specs

·        ·         In-ambulance oxygen system with liter flow device and

              manually cycled PP valve............................................................ choice of brands that meet State specs

·        ·         Mask(s) for use with PPV valve................................................... choice of brands

·        ·         Oropharyngeal airways................................................................ choice of brands

·        ·         Nasopharyngeal airways.............................................................. choice of brands

·        ·         EOA, mask, and water soluble lubricant....................................... EOAG or Combitube

·        ·         Laryngoscope handles and adult size blades................................. metal or plastic

·        ·         Magill forceps.............................................................................. none - brand specific

·        ·         Partial rebreathing mask............................................................... choice of brands

·        ·         Nasal cannula.............................................................................. choice of brands

·        ·         Nebulization device, including adult mask..................................... choice of brands

·        ·         Pocket mask with oxygen outlet................................................... choice of brands

·        ·         Oxygen connecting tubing............................................................ choice of brands

·        ·         Portable suction unit..................................................................... choice of brands that meet State specs

·         ·         Suction catheters and sterile gloves...................................................................... choice of brands

·        ·         Pneumatic compression trousers (PCT)........................................ choice of brands

·        ·         Portable ECG monitor/defibrillator with strip writer,

              synchronization capabilities, patient cable,

                   disposable chest electrodes, and defib cream................................................... choice of brands

·        ·         Donut magnet for AICD deactivation...........................................

·        ·         Catheter-over-needle IV needles, 14-20 ga................................. choice of brands

·        ·         IV lock device............................................................................. choice of brands

·        ·         IV fluid: Normal Saline - 250 ml and 500 or 1000 ml bags........... choice of brands

·        ·         IV fluid administration sets:  macrodrip and minidrip...................... choice of brands

·        ·         Other IV and drug administration supplies, i.e.,

              alcohol swabs, tourniquets, tape, armboards,

              tubex holders, syringes, and needles............................................ choice of brands

·        ·         Blood tubes and equipment for CO and blood glucose samples.... choice of brands

·        ·         Chemstrips.................................................................................. none - brand specific

·        ·         N.S. pour bottles or IV bags for irrigation.................................... choice of brands

·        ·         Sterile sheets............................................................................... choice of brands

·        ·         Bandaging equipment................................................................... to meet State specs

·        ·         Stethoscope................................................................................ choice of brands

·        ·         Sphygmomanometer and adult BP cuff......................................... choice of brands

·        ·         Poison treatment kit..................................................................... to meet State specs

·        ·         OB equipment............................................................................. to meet State specs

 

 

 

                                                                                    A-2

Required Adult ALS Equipment (continued)                                                                    Options

 

·        ·         Plastic gloves and protective face masks....................................... choice of brands

·        ·         One-way ventilation valves (for mouth-to-mask ventilation)........... choice of brands

·        ·         Protective eyewear...................................................................... choice of brands

·        ·         Protective gloves......................................................................... choice of brands

·        ·         Disinfectant solution..................................................................... choice of brands

·        ·         Puncture-proof needle disposal container..................................... choice of brands

 

 

Permitted ALS Equipment

 

·        ·         Endotracheal tubes - assorted adult sizes

·        ·         End-tidal CO2 detector

·