Air Evac
Nitroglycerine Drip - ANS-10 mcg/min, titrated up by 10 mcg to max of 200 mcg/min
Lasix Dose - ANS-40 mg or double daily dose up to 200 mg
Norepinephrine Drip - ANS-5-10 mcg/min
Epinephrine Drip - ANS-2-10 mcg/min
SIRS (systemic inflammatory response syndrome) - ANS-1) Temperature < 36 or > 38
2) HR > 90
3) RR > 20 or PaCO2 < 32
4) WBC < 4,0000 or > 12,000, or > 10% bands
Early sepsis.
Sepsis - ANS-SIRS + a documented infection
Severe Sepsis - ANS-Sepsis + end organ damage/tissue hypoperfusion (hypotension,
elevated lacate, decreased urine output)
Septic Shock - ANS-Severe sepsis + hypotension despite fluid administration
Treatment if not eligible for tPA - ANS-Treat if: SBP >200 and/or DBP > 120
Options:
a) Labetalol 10-20 mg, may repeat x1 to max total of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr to max of 15 mg/hr. Reduce to 3 mg/min when
target met.
Treatment for known hemorrhagic stroke - ANS-1) Treat pain, anxiety, nausea
If SBP remains > 150: (target 140)
a) Labetalol 10 mg q 10 min to max of 300 mg
b) Cardene 5 mg/hr titrated by 2.5 mg/hr to max of 15 mg/hr
If SBP > 220:
, a) Contact medical control or receiving facility
Treatment for unknown stroke type (scene flights) - ANS-Treat if SBP >220 or DBP >
120
Options:
a) Labetalol 10 mg q 10 min to max of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr
Target 185/110
Ruptured AAA treatment - ANS-Target: SBP 80-100 and/or HR 60
1) Treat pain with morphine
2) Labetalol 20 mg q 10 minutes doubling each dose to max total of 300 mg
Hypertensive Emergency treatment - ANS-If symptomatic with SBP > 180 and/or SBP >
120
a) Labetalol 20 mg q 10 min doubling each dose to max total of 300 mg
* MAP should not decrease by > 20% in first hour.
* Contact medical control if Labetalol is ineffective or if cocaine is suspected
Thoracic Aneurysm treatment - ANS-Target: SBP 80-100 and/or HR 60
a) Labetalol 20 mg q 10 min doubling each dose to max total of 300 mg
Treatment if patient is tPA eligible but it hasn't been given - ANS-Target: 185/110
a) Labetalol 10-20mg to max of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr
Treatment if patient is currently receiving tPA - ANS-If SBP 180-230 and/or DBP
105-120:
Labetalol 10 mg to max of 300 mg
If SBP >230 and/or DBP >120:
Nitroglycerine Drip - ANS-10 mcg/min, titrated up by 10 mcg to max of 200 mcg/min
Lasix Dose - ANS-40 mg or double daily dose up to 200 mg
Norepinephrine Drip - ANS-5-10 mcg/min
Epinephrine Drip - ANS-2-10 mcg/min
SIRS (systemic inflammatory response syndrome) - ANS-1) Temperature < 36 or > 38
2) HR > 90
3) RR > 20 or PaCO2 < 32
4) WBC < 4,0000 or > 12,000, or > 10% bands
Early sepsis.
Sepsis - ANS-SIRS + a documented infection
Severe Sepsis - ANS-Sepsis + end organ damage/tissue hypoperfusion (hypotension,
elevated lacate, decreased urine output)
Septic Shock - ANS-Severe sepsis + hypotension despite fluid administration
Treatment if not eligible for tPA - ANS-Treat if: SBP >200 and/or DBP > 120
Options:
a) Labetalol 10-20 mg, may repeat x1 to max total of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr to max of 15 mg/hr. Reduce to 3 mg/min when
target met.
Treatment for known hemorrhagic stroke - ANS-1) Treat pain, anxiety, nausea
If SBP remains > 150: (target 140)
a) Labetalol 10 mg q 10 min to max of 300 mg
b) Cardene 5 mg/hr titrated by 2.5 mg/hr to max of 15 mg/hr
If SBP > 220:
, a) Contact medical control or receiving facility
Treatment for unknown stroke type (scene flights) - ANS-Treat if SBP >220 or DBP >
120
Options:
a) Labetalol 10 mg q 10 min to max of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr
Target 185/110
Ruptured AAA treatment - ANS-Target: SBP 80-100 and/or HR 60
1) Treat pain with morphine
2) Labetalol 20 mg q 10 minutes doubling each dose to max total of 300 mg
Hypertensive Emergency treatment - ANS-If symptomatic with SBP > 180 and/or SBP >
120
a) Labetalol 20 mg q 10 min doubling each dose to max total of 300 mg
* MAP should not decrease by > 20% in first hour.
* Contact medical control if Labetalol is ineffective or if cocaine is suspected
Thoracic Aneurysm treatment - ANS-Target: SBP 80-100 and/or HR 60
a) Labetalol 20 mg q 10 min doubling each dose to max total of 300 mg
Treatment if patient is tPA eligible but it hasn't been given - ANS-Target: 185/110
a) Labetalol 10-20mg to max of 40 mg
b) Cardene 5 mg/hr, titrated by 2.5 mg/hr
Treatment if patient is currently receiving tPA - ANS-If SBP 180-230 and/or DBP
105-120:
Labetalol 10 mg to max of 300 mg
If SBP >230 and/or DBP >120:
