Protocol 2-198-50 - Cardiac Arrest - Peri-Arrest Comfort Measures

CMH EMS & MIH Protocols

RN:

• Peri-arrest patient requiring comfort measures (Hospice, TPOPP, MOLST, or POLST): Use these guidelines for comfort interventions during transport or when providing interim comfort care on site. Medications contained within the patient’s comfort kit may be used as indicated below. Do not give Narcan to comfort measures patients. If patient dies during transport, continue on to destination
• If additional comfort measure orders are specified on the form, contact MEDICAL CONTROL.
• Anxiety, agitated delirium, or hallucinations:
• Consider Ativan 0.5-2 mg PO.
• Consider Haldol 2-5 mg PO.
• Consider trial of Versed 1-3 mg IV/IN in increasing doses (max 3 mg). Watch for worsening of agitation.
• Dehydration: Consider LR 10-20 ml/kg IV.
• Click "calculate" to get dose.
• Fever:
• Consider Acetaminophen 325-650 mg PO/suppository.
• Cool cloth to forehead, neck, and/or underarms.
• Nausea:
• Consider Zofran 4-8 mg PO/IV.
• Consider Ativan 0.5-2 mg PO.
• Pain management:
• Consider Morphine 1-5 mg PO/IV every 10 minutes PRN.
• Consider Fentanyl 25-50 mcg IV/IO/IN every 10 minutes PRN.
• Work of breathing: Tachypnea, accessory muscle use, or hypoxia with agitation (Low SpO2 alone does not indicate work of breathing).
• Consider Oxygen NC max 10 LPM.
• Alert patient with history of CPAP use: Consider CPAP. Do not BVM.
• Consider Fentanyl 25 mcg with 2 ml NS Nebulized.
• Consider Versed 2-5 mg IV.

Medic:

• Ensure completion of all applicable items above.

CP:

• Ensure completion of all applicable items above.

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