City of Houston
Emergency Medical Services
Front Matter
- Introduction
- QR Codes
- Cover Sheet
- 1.00. Purpose
- 2.00. Objectives
- 3.00. Definitions
- 4.00. Scope
- 5.00. Responsibilities
6.00. Guidelines
- 6.01. Fundamental Principles
- 6.02. Ambulance Diversion
- 6.03. Communication
- 6.04. Confidential Patient Information
- 6.05. Controlled Substances Accountability
- 6.06. Documentation
- 6.07. Emergency Transfers (One Emergency Dept. to Another)
- 6.08. Equipment and Actions on Each Run
- 6.09. Family-Centered Care
- 6.10. Helicopter Utilization
- 6.11. Hospital Destination Decisions - Emergency Ambulance Routing
- 6.12. Identification Badges
- 6.13. Infection Control Precautions
- 6.14. Multiple Casualty Management
- 6.15. Medical Facility Interactions
- 6.16. Non-Transports / Refusal of Care and/or Transportation by Patients
- 6.17. Out-of-Hospital DNR Orders
- 6.18. Patient Belongings
- 6.19. Physical Restraints
- 6.20. Physician Intervener at the Scene
- 6.21. Requesting Assistance
- 6.22. Riding in Charge
- 6.23. Termination of Resuscitation
- 6.24. Voluntary Self Reporting of Medical Errors
7.00. Skills
- 7.02A. Two Person Bag-Valve-Mask Ventilation [BLS / ALS]
- 7.02B. One Person Bag-Valve-Mask Ventilation [BLS / ALS]
- 7.02C. Orotracheal Intubation [ALS]
- 7.02D. Nasotracheal Intubation [ALS]
- 7.02E. Supraglottic Airway [BLS / ALS]
- 7.02F. One-Person Bag-Valve-ET Tube/Supraglottic Airway Ventilation [BLS / ALS]
- 7.02G. Airway Foreign Body Removal (Adult / Adolescent) [BLS / ALS]
- 7.02H. Airway Foreign Body Removal (Child / Infant) [BLS / ALS]
- 7.02I. CPAP - Continuous Positive Airway Pressure [ALS]
- 7.02J. Needle Thoracostomy [ALS]
- 7.02K. Waveform Capnography - End Tidal CO₂ Monitoring [ALS]
- 7.02L. Neonatal / "Newly Born" [BLS / ALS]
- 7.02M. Oxygen Therapy Guideline [BLS / ALS]
- 7.02N. Tracheostomy Care [BLS / ALS]
- 7.03A. Airway Administration - Aerosol [BLS / ALS]
- 7.03B. Intraosseous - EZ-IO® [ALS]
- 7.03C. Intranasal (IN) - Mucosal Atomization Device
- 7.03D. Intranasal Spray - Single Dose Pre-Packaged by Manufacturer
- 7.04A. Automated External Defibrillator [BLS / ALS]
- 7.04B. Synchronized Cardioversion [ALS]
- 7.04C. Defibrillation [ALS]
- 7.04D. Cardiac Pacing - Transthoracic [ALS]
- 7.05A. Neonatal / "Newly Born" CPR (Less than 1 hour of age)
- 7.05B. Infant CPR (1 hour to < 1 year of age)
- 7.05C. Child CPR (1 year to < 8 years of age)
- 7.05D. Adolescent (8 years of age to <16 years / Adult CPR (16 years of age or greater)
- 7.06. Hemorrhage Control [BLS / ALS]
- 7.07. Extremity Splinting Skills [BLS / ALS]
- 7.08. Eye Irrigation [BLS / ALS]
- 7.09. Patient Movement [BLS / ALS]
- 7.10. Radio Report [BLS / ALS]
7.01. Patient Assessment
7.02. Airway Management
7.03. Medication Administration
7.04. Cardiac Electrical Therapy
7.05. Cardiopulmonary Resuscitation [BLS / ALS]
8.00. Guidelines / Standing Orders
- 8.01. General Principles for Guidelines / Standing Orders
- 8.02A. General Principles for Cardiac Arrest Emergencies
- 8.02B. Unresponsive Patient
- 8.02C. Pulseless Patient - BLS First on Scene
- 8.02D. Pulseless Patient - ALS First on Scene
- 8.02E. Cardiac Arrest Resuscitation
- 8.02F. Post-Cardiac Arrest Care
- 8.03A. General Principles for Medical Emergencies
- 8.03B. Abdominal Pain / Acute Abdomen
- 8.03C. Airway Obstruction (Foreign Body)
- 8.03D. Allergic Reaction / Anaphylaxis
- 8.03E. Altered Mental Status (AMS)
- 8.03F. Aortic Aneurysm / Dissection, Suspected - ADULT ONLY
- 8.03G. Bites and Stings
- 8.03H. Bradycardia (Symptomatic) - ADULT ONLY
- 8.03I. Bradycardia (Symptomatic) - PEDIATRIC ONLY
- 8.03J. Breathing Difficulty: Rales / Rhonchi (Pulmonary Edema) - ADULT ONLY
- 8.03K. Breathing Difficulty: Wheezes (Asthma / COPD) - ADULT ONLY
- 8.03L. Breathing Difficulty: Wheezes (Asthma / Bronchiolitis) - PEDIATRIC ONLY
- 8.03M. Carbon Monoxide (CO) Poisoning
- 8.03N. Chest Pain / Acute Coronary Syndrome / MI - ADULT ONLY
- 8.03O. Childbirth - Emergency (Mother)
- 8.03P. Childbirth - Emergency (Neonate / "Newly Born") - PEDIATRIC ONLY
- 8.03Q. Croup / Inspiratory Stridor - PEDIATRIC ONLY
- 8.03R. Cyanide (CN-) Poisoning
- 8.03S. Eclampsia (Pregnancy Induced Seizures) / Pre-Eclampsia
- 8.03T. Excited Delirium - ADULT ONLY
- 8.03U. Hemorrhage - Non-Traumatic GI/Rectal/Vaginal Bleed
- 8.03V. Hyperglycemia
- 8.03W. Hypertensive Emergency - ADULT ONLY
- 8.03X. Hyperthermia (Environmental / Heat Stroke)
- 8.03Y. Hypoglycemia
- 8.03Z. Hypothermia (Environmental)
- 8.03AA. Nausea / Vomiting
- 8.03BB. Organophosphate Exposure
- 8.03CC. Psychiatric Emergencies
- 8.03DD. Seizure Activity
- 8.03EE. Shock (Not Traumatic/Suspected Aortic Aneurysm) / Sepsis
- 8.03FF. Stroke (Acute) - ADULT ONLY
- 8.03GG. Syncope
- 8.03HH. Tachycardia: Narrow Complex (Symptomatic) - ADULT ONLY
- 8.03II. Tachycardia: Wide Complex (Symptomatic) - ADULT ONLY
- 8.03JJ. Tachycardia (Symptomatic) - PEDIATRIC ONLY
- 8.03KK. Therapeutic Discretion
- 8.03LL. Ventricular Assist Devices (VAD)
- 8.03MM. Water Related Emergencies
- 8.04A. General Principles for Trauma Emergencies
- 8.04B. General Guidelines for All Trauma Patients
- 8.04C. Abuse of Child / Sexual Assault of Child or Adult
- 8.04D. Bleeding Control
- 8.04E. Burns
- 8.04F. Extremity Trauma (Isolated)
- 8.04G. Fluid Resuscitation in Trauma (Blunt and Penetrating)
- 8.04H. Head Trauma (Isolated)
- 8.04I. Pain Management (Traumatic Pain)
- 8.04J. Spinal Motion Restriction
- 8.04L. Taser Injury
- 8.04M. Traumatic Arrest
- 8.04N. Trauma in Pregnancy
8.02. Cardiac Arrest Emergencies
8.03. Medical Emergencies
8.04. Trauma Emergencies
9.00. Reference Section
- Drug Guide Terminology
- 9.01A. Adenosine (Adenocard®)
- 9.01B. Albuterol Sulfate (Proventil®, Ventolin®)
- 9.01C. Amiodarone (Cordarone®)
- 9.01D. Aspirin
- 9.01E. Atropine Sulfate
- 9.01F. Calcium Chloride
- 9.01G. Dexamethasone (Decadron®)
- 9.01H. Dextrose - Oral (Oral Glucose)
- 9.01I. Dextrose in Water (D10W or D50W)
- 9.01J. Diltiazem (Cardizem®)
- 9.01K. Diphenhydramine (Benadryl®)
- 9.01L. Epinephrine Hydrochloride (Adrenalin®)
- 9.01M. Fentanyl
- 9.01N. Hydroxocobalamin (Cyanokit®)
- 9.01O. Ipratropium Bromide (Atrovent®)
- 9.01P. Labetalol (Trandate®, Normodyne®)
- 9.01Q. Lidocaine Hydrochloride (Xylocaine®)
- 9.01R. Magnesium Sulfate
- 9.01S. Methylprednisolone (Solumedrol®)
- 9.01T. Midazolam (Versed®)
- 9.01U. Naloxone Hydrochloride (Narcan®)
- 9.01V. Nitroglycerin
- 9.01W. Norepinephrine (Levophed®)
- 9.01X. Ondansetron (Zofran®)
- 9.01Y. Oxygen
- 9.01Z. Sodium Bicarbonate
- 9.01AA. Sodium Chloride (0.9%) (Normal Saline)
- 9.01BB. Pediatric Dosing Guidelines - Medication
- 9.01CC. Pediatric Dosing Guidelines - Equipment / Therapies
- 9.02. Common Abbreviations
- 9.03. Equipment Requirements
- 9.04. Procedure for Downloading AED and LifePak 15 Data
- 9.05. Approved Hospitals and Hospitals with Specialized Facilities
- 9.06. Revisions to Guideline
9.01. Pharmacology Guide
Pediatric Dosing Guidelines
- Preemie - 2 KG
- Newborn - 4 KG
- 4 Months - 6 KG
- 6 Months - 8 KG
- 1 Year - 10 KG
- 2 Years - 12 KG
- 3 Years - 15 KG
- 4 Years - 17 KG
- 5 Years - 20 KG
- 6 Years - 22 KG
- 7 Years - 25 KG
- 8 Years - 27 KG
- 9 Years - 30 KG
- 10 Years - 35 KG
- 11 Years - 40 KG
- 12 Years - 50 KG
- 13-15 Years - 60 KG
III-09 MCI Guidelines
- MCI.1. Purpose
- MCI.2. Objectives
- MCI.3. Definitions
- MCI.4. Scope
- MCI.5. Responsibilities
- MCI.6. Guidelines
- MCI.A1. Attachment 1 — CMOC
- MCI.A2. Attachment 2 — Special Considerations in Management of MCI
- MCI.A3. Attachment 3 — EMS Regional Disaster Tag Guidelines
- MCI.A4. Attachment 4 — MCI Checklist
- MCI.A5. Attachment 5 — Hospital Capabilities
- MCI.A6. Attachment 6 — Medical Branch Incident Command
- MCI.A7. Attachment 7 — START-JumpSTART Triage
- MCI.A8. Attachment 8 — Downtime MCI Register
Tables
- Table 6-1. Estimated LifeFlight Time from Request to Arrival at Hermann Hospital
- Table 6-2. Hospital Destination Decision
- Table 6-3. Criteria for Trauma Center Transport
- Table 7-1. Bag-Valve-Mask Ventilation
- Table 7-2. AVPU Mental Status Exam
- Table 7-3. OPQRST Questions
- Table 7-4. AMPLE History
- Table 7-5. BTLS Secondary Survey (Head to Toe Exam)
- Table 7-6. CHAMPION Physical Exam
- Table 7-7. Glasgow Coma Scale : Adult and Pediatric
- Table 7-8. Oxygen Therapy Guideline
- Table 7-9. CPR Parameters, All Ages
- Table 8-1. Patient Age Distributions
- Table 8-2. Normal Vital Signs by Age Group
- Table 8-3. Signs of Poor Perfusion: Pediatric
- Table 8-4. APGAR Score
- Table 8-5. Rule of Nines
- Table 8-6. Pain Scales
- Table 8-7. Criteria for Trauma Center Transport
- Table 8-8. Glasgow Coma Scale: Adult and Pediatric
- Table 9-1. Epinephrine Concentration Chart
- Table 9-2. Hydroxocobalamin (Cyanokit®) Pediatric Dosing
- Table 9-3. Oxygen Administration
Hospital Specialties
- Level I / II Trauma Centers
- Level III Trauma Centers
- Pediatric Trauma Centers
- Stroke 1 Comprehensive
- Stroke 2 Primary
- 24 Hour Cardiac Cath
- Post-Arrest Hypothermia
- VAD Facility
- Burn Care
- Hyperbaric Txt
- Obstetric Specialty
- Pediatric ICU
- SAFE Certified
Shift Calendar
Last updated: 2023-01-24