Beruflich Dokumente
Kultur Dokumente
Approved by the
State of New Jersey Department of Health and Senior Services
Office of Emergency Medical Services
Adopted by the
State of New Jersey
Office of Information Technology
Office of Emergency Telecommunications Services
January 2004/Updated April 2006/March 2007/July 2009
Dispatch ALS & BLS, advise caller help has been dispatched.
ASSAULT/ DOMESTIC, SEXUAL State of New Jersey EMD Guidecards Version 1/04
Remain in a safe place, away from the assailant. Advise patient not to change clothing, bathe or shower.
Have patient lie down and keep calm. Gather patient medications, if possible.
Do not touch weapons. Do not allow the patient any food or drink.
If bleeding, use clean cloth and apply pressure directly over it. Lock away any pets.
If cloth becomes soaked, do not remove, add to
what is already there. Use care not to obstruct the If the patient’s condition changes, call me back.
airway or breathing.
K
E Is patient alert? IF INJURY
Y From where?
Is patient breathing normally? How much?
Q How long?
U Where is the bleeding from? Can it be controlled with pressure?
E If vaginal, is she pregnant?
S Can the patient answer your questions?
T Is blood squirting out?
I
O Is the patient a hemophiliac (a bleeder)?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Unconscious/not breathing normally.
D Decreased level of consciousness.
I Minor bleeding from any other area
Any arterial bleeding.
S Hemophilia.
P Rectal bleeding with significant blood loss.
A Vomiting blood or coffee ground material.
T Bleeding from mouth with difficulty breathing.
C Bleeding from the neck, groin, or armpit with significant
H blood loss.
Vaginal bleeding if over 20 weeks pregnant, associated
with lower abdominal pain or fainting.
BLEEDING / LACERATION Pre-Arrival Instructions
If bleeding, use clean cloth and apply pressure directly Nothing to eat or drink.
over wound. Do not remove. If cloth becomes soaked,
add more to what is already there. Gather patient medications, if possible.
If nosebleed, tell the patient to apply direct pressure by Locate any amputated part and place in clean plastic bag,
pinching the nose tightly between their index finger and not ice. If teeth, place them in milk.
thumb, sit forward and hold it until help arrives. Attempt
to spit out blood, swallowing may make patient nauseous. If the patient’s condition changes, call me back.
EYE PROBLEMS / INJURIES State of New Jersey EMD Guidecards Version 1/04
K
E Is patient alert?
Is eyeball cut open or leaking fluid?
Y
Is patient breathing normally?
Are there any other injuries?
Q
U What caused the injury?
E Chemicals
S Foreign object
T Impaled object
I Direct blow
O Flying object
N Welding/near welder
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Unconscious/not breathing normally. Any eye injury
S Decreased level of consciousness.
P
A
T
C
H
EYE PROBLEMS / INJURIES Pre-Arrival Instructions
K
E Is patient breathing normally?
Is the patient able to move their fingers and toes?
Y (Do not have them move any other body part).
Is patient alert?
Q Is the patient bleeding?
U How far did the patient fall?
IF YES,
E From where?
S What kind of surface did the patient land on?
How much?
T How long?
I Are there any obvious injuries? What are they?
O
N Did the patient complain of any pain or illness just
S prior to the fall?
Turn off any machinery. If bleeding, use clean cloth and apply pressure directly over
it. If cloth becomes soaked, do not remove, add to what is
Do not move the patient if there are no hazards already there. Use care not to obstruct the airway or
breathing.
Advise patient not to move
Gather patient medications, if possible.
Cover patient with blanket and try to keep them calm.
If the patient’s condition changes, call me back.
No food or drink.
HEAT / COLD EXPOSURE State of New Jersey EMD Guidecards Version 1/04
K
E Is patient alert? Does the patient respond to you and follow simple
Y Is patient breathing normally? commands?
What happened? Can the patient answer your questions?
Q What was the source of the heat or cold? Is the patient acting normal for him or her?
U What was the length of exposure? If not, what is different?
E Does the patient have any complaints? Is the patient sweating profusely?
S Is the patient complaining of pain? If so where? How does the patient act when he/she sits up?
T Can the patient talk in full sentences? Is the patient dizzy, weak, or feeling faint?
I
O
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Unconscious/not breathing normally. Patient with uncontrollable shivering.
S Decreased level of consciousness. Heat Exhaustion with no critical symptoms
P Confused/disoriented.
A Fainting (Syncope).
T Cold Water Submersion
C
H
HEAT / COLD EXPOSURE Pre-Arrival Instructions
Remove from hot/cold environment as necessary. Nothing by mouth if there is a decrease of consciousness.
If patient is cold and dry, cover patient. Do not rub frostbitten extremities.
If patient is cold and wet, remove clothing and cover Gather patient medications, if possible.
patient
If the patient’s condition changes, call me back .
If patient is over-heated, loosen clothing to assist cooling.
K Is patient alert?
E Is the patient bleeding?
Y Is patient breathing normally?
IF YES,
Q Are there any obvious injuries? What are they? From where?
U How much?
E What part of the body has been amputated? How long?
S Can it be controlled with pressure?
T Do you have the amputated parts?
I Is the patient entrapped?
O Is the patient able to move their fingers and toes?
N (Do not have them move any other parts of
S their body).
SIMULTANEOUS ALS/BLS BLS DISPATCH
Have someone meet the ambulance to guide them to the If the patient’s condition changes, call me back.
patient.
Tell caller to remain safe (beware of assailant). Have the patient lie down and remain calm.
Do not disturb the scene or move weapons. Keep the patient warm.
Do not pull out any penetrating weapons. If the patient’s condition changes, call me back.
K
E Is patient alert? Is the patient bleeding?
Y IF YES,
Is patient breathing normally? From where?
Q (Consider breathing card) How much?
U How long?
E How was the patient injured? Can it be controlled with pressure?
S
T Where is the patient injured?
I
O Describe what happened.
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Do not move patient, unless there are hazards. Keep patient warm.
If bleeding, use clean cloth and apply pressure directly Gather patient medications, if possible.
over it.
Locate any amputated parts and place in clean plastic bag,
If cloth becomes soaked, do not remove, add to what is not on ice. If teeth, place in milk.
already there.
If the patient’s condition changes, call me back.
Use care not to obstruct the airway or breathing.
VEHICULAR RELATED INJURIES State of New Jersey EMD Guidecards Version 1/04
K
Are there any hazards present? (Is the scene safe). Can the patient(s) describe where their pain is
E
Fire located?
Y
Water
HazMat What type of vehicle(s) are involved?
Q
Wires down
U
Is patient alert? Describe what happened?
E
Is patient breathing normally?
S
(Consider breathing card). Are all of the patients free of the vehicle?
T
Did you stop or drive by?
I
How many patients are injured? Is anyone trapped in the vehicle?
O
N
S Was anyone thrown from the vehicle?
SIMULTANEOUS ALS/BLS BLS DISPATCH
Unconscious/not breathing normally.
D Decreased level of consciousness.
I Chest pain prior to accident. Accident with injury, no critical criteria.
S Reported injuries with following mechanisms: Police request stand-by/check for injuries.
P Vehicle (car/motorcycle) vs. immovable objects.
A Vehicles involved in head-on or T-bone collision.
T Car vs. pedestrian, motorcycle or bicycle.
C Patient(s) trapped or ejected.
H Vehicle roll over.
Critical criteria – injuries to head, neck, torso, thigh.
Multiple Casualty Incident
VEHICULAR RELATED INJURIES Pre-Arrival Instructions
.
Do not move patient unless there are hazards.
K
E Is patient alert? If the patient is a woman between 12-50 years, ask
Y Is patient breathing normally? (Consider breathing Could she be pregnant?
card) Has she said she felt dizzy?
Q Is the pain due to an injury to the patient? Has there been vaginal bleeding? If yes, how
U Has the patient vomited? If yes, What does the vomit much?
E look like? How does the patient act when he/she sits up?
S Are the patient's bowel movements different than Does the patient have any other medical or surgical
T normal? history?
I If yes, How would you describe them? Is the patient wearing a Medic Alert tag?
O Is the pain above the belly button? If yes, what does it say?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Unconscious/not breathing normally.
D Decreased level of consciousness.
I Vomiting blood (red/dark red) or coffee ground-like Pain with vomiting.
S substance. Flank pain (Kidney stone).
P Black tarry stool.(Caution: Could be a resultant from diet Abdominal (non-traumatic).
A supplements) Pain unspecified.
T Lower abdominal pain, woman 12-50 years (if associated
C with dizziness or fainting or heavy vaginal bleeding).
H Upper abdominal pain with prior history of heart problem.
Abdominal pain with fainting or near fainting, patient over
50 yrs.
Fainting/near fainting when sitting. (hypotension)
ABDOMINAL PAIN Pre-Arrival Instructions
.
Nothing to eat or drink.
K
E Is patient alert? Does the patient have a history of a reaction to
Y Is patient breathing normally? (Consider breathing anything?
card) IF YES:
Q What is the patient complaining of? Describe the reaction the patient had before.
U Is the patient having difficulty swallowing? How long ago was the patient exposed?
E How does the patient act when they sit up?
S Does the patient have a rash or hives? Are the symptoms getting worse?
T Is the patient complaining of itching?
I Is the patient wearing a Medic Alert tag?
O If yes, what does it say?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Have the patient rest in the most comfortable position. Gather patient medications, if any.
Keep neck straight – remove pillows. Do you have a Epi-Pen or reaction kit? Yes or No
If yes, have you used it as the physician has directed?
Watch patient for signs of difficulty breathing (slow
breathing), or cardiac arrest. If the patient’s condition changes, call me back.
Keep calm.
Ice to sting.
K
E Is patient alert? Does the patient have any other medical or surgical
Y history?
Is patient breathing normally? (Consider breathing
Q card) Is the patient wearing a Medic Alert tag? If yes,
U what does it say?
E Is the pain due to an injury to the patient?
S
T Has the patient felt dizzy or fainted?
I
O
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
K Is patient alert?
E Is patient breathing normally? If sudden onset:
Y How long has this been going on? Has the patient been hospitalized recently for
What has changed in their breathing to prompt you to childbirth or a broken leg?
Q call? If female, does the patient take birth control pills?
U Is the patient able to speak in full sentences? Could the patient be having an allergic reaction?
E Does the patient have to sit up to breathe? Is the patient drooling of having a hard time
S Is the patient experiencing any other problems right swallowing?
T now? Are they on asthma medication, or ever used
I Has the patient ever had this problem before? them?
O What was the patient doing just prior to when he/she Does the patient have any other medical or surgical
N became short of breath? history?
S Is the patient on oxygen?
CHEST PAIN/HEART PROBLEMS State of New Jersey EMD Guidecards Version 4/06
Is patient alert?
K
Is patient breathing normally? (Consider breathing
E Is the patient sweating profusely?
card)
Y Is the patient experiencing rapid heart rate with
Where in the chest is the pain located?
Does the patient feel pain anywhere else? If so, where? chest pain?
Q Does the patient have a history of rapid heart rate?
How long has the pain been present?
U How does the patient act when he/she sits up?
Does the pain change when the person breathes or
E Is the patient weak, dizzy, or faint?
moves?
S
Does the patient take nitroglycerin? Have they taken it?
T
Has the patient ever had heart surgery or a previous
I
heart attack?
O
Has the patient ever had a heart problem?
N
Is the patient nauseated or vomiting?
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Have the patient sit or lie down, whichever is more Can the patient take asprin?
comfortable. If yes: then ask-Have they had any bleeding from
mouth or rectum?
Keep patient calm. If no bleeding, advise caller to assist patient to take 1
adult asprin.
Loosen any tight clothing.
Gather patient medications, if any.
Does the patient have nitroglycerin?
If yes: Has the patient taken one? If the patient’s condition changes, call me back.
if not taken, take as the physician has directed
(patient should be seated).
K
E Is patient alert? Is the patient sweating profusely?
Y Is patient breathing normally? Has the patient had a seizure?
(Consider breathing card) Is the patient on insulin? If so, when did they take
Q Do they know who they are and where they are? their medication?
U Is the patient acting in their normal manner. If not, When did the patient last eat?
E what is different?
S Is the patient complaining of any pain? Where is it
T located?
I How does the patient act when he/she sits up?
O Are they dizzy, weak, or feeling faint?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
K
E Is patient alert? What was the patient doing when the headache
Y Is patient breathing normally? started?
(Consider breathing card) Does the patient have pain anywhere else? If so,
Q How is the patient acting? If unusual, what is different where?
U about them? Has the patient had a recent illness or injury? If so,
E Does the patient know where they are and who they what?
S are? Does the patient have a headache history?
T Is the headache different than headaches the patient Is the patient wearing a Medic Alert Tag? If so,
I has had in the past? what does is say?
O Did the headache come on suddenly or gradually?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Headache with these critical symptons: Headache without critical symptoms.
S Decreased level of consciousness.
P Mental status change.
A Worst headache ever.
T Sudden onset.
C Visual disturbance, with no history of migraines.
H
HEADACHE Pre-Arrival Instructions
.
Nothing by mouth.
K Is patient alert?
E Is patient breathing normally? (Consider breathing Has the patient used street or non-prescription
Y card) drugs?
Do you have any idea what the patient took? If yes, with alcohol?
Q Is the patient acting normally for him or her? If not, If cocaine or crack, is the patient complaining of
U what is different? any pain?
E If the patient took medications, were they prescription (If chest pain go to chest pain card)
S medications? Where?
T What medication did they take? How much? Is the patient violent? Do they have access to a
I If it was not medication, what type of substance did weapon?
O the patient take? Has the patient vomited?
N Is the patient having difficulty swallowing? If yes, describe.
S How old is the patient?
SIMULTANEOUS ALS/BLS BLS DISPATCH
PSYCHIATRIC/BEHAVIORAL PROBLEMS
State of New Jersey EMD Guidecards Version 1/04
K Is patient alert?
E Is patient breathing normally? Can the patient talk to you?
Y (Consider breathing card) Can the patient answer your questions?
What happened? Has the patient taken any drugs or alcohol?
Q Has the patient harmed himself? (Consider OD/POISIONING card)
U IF YES: (Consider trumatic injury card) Does the patient have a weapon or access to a
E With what? weapon?
S Where are the injuries? Is patient a diabetic? (Consider diabetic card)
T Is the patient acting in their normal manner? Is the scene secure?
I If not, what is different or unusual?
O Where is the patient now?
N Do you think the patient might harm himself?
S If so, with what?
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Decreased level of consciousness Lacerated wrist(s) with controlled bleeding.
S Unusual behavior with a psychiatric history.
P Known alcohol intoxication without other drugs (can
A be aroused).
T Threats against self or others.
C Police request for stand-by.
Patient out of psychiatric medications
H
PSYCHIARTIC / BEHAVIORAL PROBLEMS Pre-Arrival Instructions
.
Keep the patient in area, if safe.
K
E Is the patient a diabetic? (Consider diabetic card).
Y Is patient alert?
Is patient breathing normally? If child:
Q Describe what the patient is doing. Has the child been sick?
U Is the patient still seizing? Does the child have a fever or feel hot?
E How long has the patient been seizing? If female:
S Has the patient had a seizure before? Is the woman pregnant?
T Does the patient have a medic alert bracelet on? Is the patient a recreational drug user?
I If yes, what does it say? Has the patient had a recent head injury?
O If yes, before or after the seizure?
N Within the last three days?
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Unconscious/not breathing normally.
D Decreased level of consciousness.
I
Not breathing after seizure stops. Single seizure with history of seizure disorder
Extended seizures greater than 5 minutes.
S Multiple seizures.
P Febrile seizures.
A First time seizure or seizure, unknown history.
T Diabetic.
C Pregnant.
H Secondary to drug overdose.
Secondary to recent head injury.
Any seizure that is different than normal
SEIZURES / CONVULSIONS Pre-Arrival Instructions
Clear area around the patient. If patient is a child, remove clothing to cool patient if hot
and feverish.
Do not restrain patient.
Gather patient medications, if any.
Do not place anything in patient's mouth.
If the patient’s condition changes, call me back.
After seizure has stopped, check to see if patient is breathing.
If not, Determine appropriate age group.
Go to CARDIAC/RESPIRATORY ARREST instructions
for appropriate age group
UNKNOWN / MAN DOWN State of New Jersey EMD Guidecards Version 1/04
K
E Is patient alert?
What was patient doing?
Y Is patient able to move at all?
Is patient breathing normally? (Consider breathing
Q card)
Where exactly is the patient?
U
E Why is the patient down?
S If determined, go to appropriate card.
T
I Is patient able to talk?
O
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Unconscious/not breathing normally. Unknown (Third Party Call) without indications of
S Decreased level of consciousness. unconsciousness.
P Patient talking, moving, sitting, or standing
Multiple Casualty Incident Criteria.
A
T
C
H
UNKNOWN / MAN DOWN Pre-Arrival Instructions
.
If there is no danger, go to patient to see if patient is
awake, breathing normally, or moving at all.
K Is patient alert?
E
Y Is patient breathing normally? (Consider breathing
card)
Q
U What is the source of the contamination?
E
S Has the patient been removed from the area or
T source of contamination?
I
O Is a CO Detector activated?
N
S What is the name of the contaminating agent?
Critical Symptoms:
D Unconscious/LOC/not breathing normally.
I Chemicals on patient’s skin or clothing, no critical
Decreased level of consciousness. symptoms.
S Ingestion / inhalation household cleaners, antifreeze,
P Third party report, caller not with patient
solvents, methanol, cyanide, or insecticides.
A Difficulty swallowing/breathing.
T Multiple Casualty Incident.
C
H
CO / INHALATION / HAZMAT Pre-Arrival Instructions
Prevent self contamination. Flush chemicals from burns to eyes, remove contacts
Have patient remove contaminated clothing, if possible. Place burned area in cool water (not ice), if convenient.
Remove contact lenses, if possible. If the patient’s condition changes, call me back.
CARDIAC ARREST / DOA State of New Jersey EMD Guidecards Version 1/04
K Is patient alert?
E If unsure about breathing, interrogate further:
Y Is patient breathing normally? (Consider breathing a. Have the caller go and see if the chest rises,
card) then come back to the phone.
Q b. Listen for the sound, frequency and
U If unsure about consciousness, interrogate further: description of breaths.
E a. Does the patient respond to you?
S Talk to you? Answer questions? Hear you? Agonal respirations are often reported as:
T b. Does the patient move? gasping, snoring, or gurgling
I Flinch? Move arms or legs? barely breathing
O c. Are the pupils fixed and dilated? moaning weak or heavy
N occasional
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Agonal respirations are ineffective breaths which occur after cardiac Age
arrest Sex
Specific location
Chief complaint
Pertinent related symptoms
Medical/Surgical history, if any
Other agencies responding
Any dangers to responding units
REMEMBER, FLAT on their BACK. BARE the CHEST. PINCH the NOSE SHUT.
With your OTHER hand, LIFT the CHIN so the head BENDS BACK.
GIVE TWO BREATHS. THEN COME BACK TO THE PHONE!
If I’m not here stay on the line.
OK Reported Patient Vomited HYSTERICAL STOMA
(RESUME)
Is there an automatic Open the machine and turn it on. Follow the voice prompts and
defibrillator in the area? instructions from the machine.
Use large size pads on adults.
NO YES
Come back to the phone when the machine tells you to do CPR and I
will help you.
Put the HEEL of your HAND on the CENTER of their CHEST, right BETWEEN the NIPPLES.
Put your OTHER HAND ON TOP of THAT hand.
PUSH DOWN on the HEELS of your hands, 1-½ to 2 inches.
Do it 30 times, PUSH HARD AND FAST.
MAKE SURE the HEEL of your hand is on the CENTER of their chest, RIGHT BETWEEN THE NIPPLES.
IF NOT PERFORMING MOUTH TO MOUTH BREATHING, ADVISE to PUMP the CHEST 200 times and then come
back to the phone.
OK HYSTERICAL
REMEMBER, FLAT on their BACK. BARE the CHEST. PINCH the NOSE SHUT.
With your OTHER hand, LIFT the CHIN so the head BENDS BACK.
GIVE TWO BREATHS. THEN COME BACK TO THE PHONE!
If I’m not here stay on the line.
OK Reported Patient Vomited HYSTERICAL STOMA
(RESUME)
Put the HEEL of ONE HAND on the CENTER of the child’s CHEST, right BETWEEN the NIPPLES.
PUSH DOWN FIRMLY, ONLY on the HEEL of your hand, HALFWAY DOWN.
Do it 30 times, PUSH HARD AND FAST.
Then, PINCH the NOSE SHUT and LIFT the CHIN so the head TILTS BACK. (If being performed).
TWO MORE BREATHS and PUMP the CHEST 30 times.
KEEP DOING IT; PUMP the CHEST 30 times. Then TWO BREATHS. (If being performed).
KEEP DOING IT UNTIL HELP CAN TAKE OVER.
I’ll stay on the line.
OK I CAN’T OR HYSTERICAL
After 2 minutes
of CPR
Is there an automatic Open the machine and turn it on. Use child AED pads
if equipped. (If using adult pads on a child be sure
defibrillator in the they do not touch each other). Follow the voice
area? prompts and instructions from the machine. Come back
NO YES to the phone when the machine tells you to do CPR and
I will help you again.
(RESUME)
OK HYSTERICAL
K
E Is patient alert? Is the patient able to speak or cry?
Y
Is patient breathing normally? Is the patient turning blue?
Q (Consider breathing card)
U How old is the patient?
E Describe the breathing.
S Does the chest rise?
T Does air enter freely?
I
O
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Unconscious/not breathing normally. Able to speak or cry.
S Unable to talk or cry. Exchanging air with no breathing difficulty.
P Turning blue. Airway cleared, patient assist.
A
T
C
H
CHOKING Pre-Arrival Instructions
.
Determine age group.
Is the patient?
MOVING or
BREATHING?
ROLL the patient on their SIDE and CHECK
NO YES
BREATHING until help takes over.
PINCH the nose SHUT. With your OTHER hand, LIFT the CHIN so the head BENDS BACK.
COMPLETELY COVER their mouth with your mouth.
GIVE TWO BREATHS OF AIR into the patients LUNGS--just like you’re blowing up a
balloon.
Watch to see if the CHEST GENTLY RISES.
(RESUME)
Put the HEEL of your HAND on the CENTER of their CHEST, right BETWEEN the NIPPLES.
Put your OTHER HAND ON TOP of THAT hand.
PUSH DOWN on the HEELS of your hands, 1-½ to 2 inches.
Do it 30 times, PUSH HARD AND FAST.
MAKE SURE the HEEL of your hand is on the CENTER of their chest, RIGHT BETWEEN THE NIPPLES.
Then, PINCH the NOSE SHUT and LIFT the CHIN so the head BENDS BACK.
OPEN THE MOUTH. If you see something, try to sweep it out. DON’T push the object backwards.
TWO MORE BREATHS and PUMP the CHEST 30 times.
KEEP DOING IT; PUMP the CHEST 30 times. Then TWO BREATHS
OPEN THE MOUTH. If you see something, try to sweep it out. DON’T push the object backwards.
Is there an automatic Open the machine and turn it on. Follow the voice prompts and instructions from the machine.
defibrillator in the area? Use large size pads on adults.
NO YES Come back to the phone when the machine tells you to do CPR and I will help you.
Is the child
MOVING or
BREATHING?
NO YES
ROLL the child on their SIDE and CHECK
BREATHING until help takes over.
PINCH the nose SHUT. With your OTHER hand, LIFT the CHIN so the head TILTS BACK.
COMPLETELY COVER their mouth with your mouth.
GIVE TWO BREATHS OF AIR into the child’s LUNGS--just like you’re blowing up a balloon.
Watch to see if the CHEST GENTLY RISES.
(RESUME)
Put the HEEL of ONE HAND on the CENTER of the child’s CHEST, right BETWEEN the NIPPLES.
PUSH DOWN FIRMLY, ONLY on the HEEL of your hand, HALFWAY DOWN.
Do it 30 times, PUSH HARD AND FAST.
Then, PINCH the NOSE SHUT and LIFT the CHIN so the head TILTS BACK.
OPEN THE MOUTH. If you see something, try to sweep it out. DON’T push the object backwards.
TWO MORE BREATHS and PUMP the CHEST 30 times.
KEEP DOING IT; PUMP the CHEST 30 times.
OPEN THE MOUTH. If you see something, try to sweep it out. DON’T push the object backwards.
Then TWO BREATHS.
I’ll stay on the line.
After 2 minutes
of CPR
Open the machine and turn it on. Use child AED pads if equipped. (If
Is there an automatic using adult pads on a child be sure they do not touch each other).
defibrillator in the area? Follow the voice prompts and instructions from the machine. Come
back to the phone when the machine tells you to do CPR and I will help
NO YES you again.
Turn the baby FACE DOWN so it lies along your forearm; SUPPORT the baby’s JAW in
your HAND.
Lower your arm onto your thigh so that the baby’s head is LOWER than its chest.
Use the HEEL of your other HAND to strike the BACK 5 times FIRMLY, right between
the shoulder blades.
Do that, and come back to the phone.
SANDWICH the baby between your forearms, SUPPORT the head, and then turn the baby
onto its back.
Put your INDEX AND MIDDLE FINGERS directly BELOW the baby’s NIPPLES.
Push down halfway, do it 5 TIMES. (1-2-3-4-5). Do that, and come back to the phone.
Baby becomes unconscious. Object dislodged. Still conscious and choking, repeat sequence.
(RESUME)
Listen carefully. I’ll tell you what to do. Lay the baby FLAT on it’s back on a
hard surface, such as the floor or a table, and then BARE the baby’s chest.
Do that then come back to the phone. If I’m not here, stay on the line.
(RESUME)
Is the baby?
BREATHING or
CRYING?
NO YES ROLL the baby on their
SIDE and CHECK
BREATHING until help
takes over.
K Is patient alert?
E Has the patient been removed from the water?
Y Is patient breathing normally? (Consider breathing
card) Is the patient on land or in a boat?
Q
U How long was the patient under water? What was the patient doing before the accident?
E
S Is this a scuba diving accident?
T
I
O
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
D
I Unconscious, not breathing normally. Patient not submerged.
S Difficulty breathing. Patient coughing.
P Scuba diving accident. Other injuries without critical symptoms.
A Diving accident (possibility of C-spine injury.) Minor injury (lacerations/fractures).
T Fractured femur (thigh).
C
H
DROWNING (POSSIBLE) Pre-Arrival Instructions
.
Do not attempt to rescue patient, unless trained to do so.
K Is patient alert?
E
Y Is patient breathing normally? (Consider breathing
card)
Q
U If household electrocution, was it the dryer, stove, or
E other 220 volt source.
S
T Is patient still in contact with the source?
I
O Are there any other injuries? If so what are they?
N
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
CHILDBIRTH INSTRUCTIONS
START Has she had a baby before? PROMPT: DO NOT allow
patient to use the toilet!
YES NO
How far apart are the contractions (pains)? How far apart are the contractions (pains)?
Less than More than More than Less than
5 Min. 5 Min. 2 Min. 2 Min.
Does she have a strong desire to push? Does she have a strong desire to push?
Listen carefully. I’ll tell you what to do.
YES NO Have her LIE in a comfortable position, NO YES
LEFT SIDE IS BEST.
Have her take DEEP breaths.
Monitor patient’s condition.
If a STRONG DESIRE TO PUSH develops delivery may be imminent, if so continue.
Ask her to RESIST urge to PUSH or BEAR DOWN.
Get the phone next to her if you can.
Ask her to LIE on her BACK and relax, breathing DEEPLY through her
MOUTH.
Ask her to remove her underwear.
Place clean towels UNDER her BUTTOCKS. Have additional towels ready.
<<< If she starts to deliver (water broken, bloody discharge, baby’s head appears) >>>
The baby’s head should appear first. CRADLE it and the rest of the baby as it is delivered.
DO NOT PUSH OR PULL.
There will be water and blood with delivery. THIS IS NORMAL.
When the baby is delivered, CLEAN out it’s MOUTH and NOSE with a CLEAN, DRY CLOTH.
DO NOT attempt to CUT or PULL the cord.
Wrap the baby in a dry blanket, a towel, or whatever is handy, and place it between the mother’s legs on
the floor. Massage the mother’s lower abdomen very gently.
If the baby DOES NOT start breathing on its own, rub its back or gently slap the soles of its feet.
If the baby DOESN’T begin breathing IMMEDIATELY, come back to the phone.
COMPLICATIONS with delivery Baby delivered and BREATHING Baby delivered and NOT BREATHING
<< If there are complications (leg, arm, buttocks, or umbilical cord presenting) >>
REASSURE the mother. Tell her you have dispatched aid.
Ask her to remain on her BACK with her KNEES BENT.
Ask her to RELAX and BREATHE through her MOUTH.
Tell her NOT TO PUSH.
K Is patient alert?
Is patient breathing normally? Did the patient have any complaints just before
E they became unconscious?
Y (Consider breathing card)
Is this the first time today the patient has been What were they?
unconscious? How does the patient act when they sit up?
Q Is the patient able to respond to you and follow
U Have you or anyone else tried to wake the patient up?
Has the patient taken any medication or recreational simple commands?
E Can the patient answer your questions?
S drugs with alcohol?
What was the patient doing before they became Has the patient been drinking alcohol?
T Does the patient have a medic alert tag?
I unconscious?
Does the patient have any medical or surgical If yes, what does it say?
O
N history?
What?
S
SIMULTANEOUS ALS/BLS BLS DISPATCH
Unconscious/not breathing normally.
Multiple fainting (syncopal) episodes (same day). Unconscious, but now conscious without critical
D symptoms.
Confirmed unconscious/unresponsive greater then one
I Unconfirmed slumped over wheel.
minute.
S Conscious with minor injuries.
Combined drugs and alcohol overdose.
P Known alcohol intoxication without other drugs,
Difficulty breathing.
A can be aroused.
Fainting associated with: Headache, Chest
T Near Syncope (fainting) without critical criteria.
pain/discomfort/palpitations, Diabetic, GI/Vaginal
C
Bleeding, Abdominal pain, Sitting/Standing, or
H Continued decreased level of consciousness.
Single fainting if over 50 years.
Alcohol intoxication, can not be aroused
UNCONSCIOUS / FAINTING Pre-Arrival Instructions
.
Have patient lie down.
START
START
HAZMAT INCIDENT GUIDE State of New Jersey EMD Guidecards Version 1/04
K Where is the emergency? Actual incident location, Are there any injuries?
E direction of travel if applicable: IF NO: go to next question
Y IF YES:
Best access route to facility: How many people are injured?
Q What is the nature of the injuries?
U Are you in a safe location? If YES: continue questioning Refer to appropriate medical guidecard or local protocol
E If NO: advise caller to move to safe location and call back
S Type of hazardous material Incident: Name and/or ID # of material:
T Explosion Odor Complaint
I Fire Air release State of material: Solid Liquid Gas
O Motor Vehicle Accident Illegal dumping
N Leak / Spill Other:
S Abandoned container / materials
EMERGENCY MEDICAL DISPATCH Hazardous Materials Agency Dispatch
D
I Refer to the appropriate medical guidecard or Notify County and all applicable
S follow local protocol. agencies (NJDEP, Local and/or County
P OEM, etc.) per local protocol on any
A affirmative responses to items marked *
T
C in the prompts section below.
H
HAZMAT INCIDENT GUIDE Pre-Arrival Instructions
If you are not in a safe location, leave the area and call back. .
Gather available chemical information
Deny entry to affected area. Secure premises, isolate area.
Isolate injured from scene if safely possible.
ENVIRONMENTAL FACTORS
INDICATORS OF SEVERE ANATOMIC OR
• The time needed to transport a patient by ground to an PHYSIOLOGIC COMPROMISE
appropriate facility poses a threat to the patient’s survival and
recovery. • Unconsciousness or decreasing level of consciousness.
• Weather, road, and traffic conditions would seriously delay the • Systolic blood pressure less than 90 mmHg.
patient's access to Advanced Life Support (ALS).
• Respiratory rate less than 10 per minute or greater than 30 per
• Critical care personnel and equipment are needed to minute.
adequately care for the patient during transport.
• Glasgow Coma Score less than 10.
• Falls of 20 feet or more.
• Compromised airway.
• Motor vehicle accident (MVA) of 20 MPH or more without
restraints. • Penetrating injury to chest, abdomen, head, neck, or groin.
• Rearward displacement of front of car by 20 inches. • Two or more femur or humerus fractures.
• Rearward displacement of front axle. • Flail chest.
• Passenger compartment intrusion. • Amputation of an extremity.
• Ejection of patient from vehicle. • Paralysis or spinal cord injury.
• Rollover. • Severe burns.
• Deformity of a contact point (steering wheel, windshield,
dashboard).
• Death of occupant in the same vehicle.
• Pedestrian struck at 20 MPH or more. 1-800-332-4356
REMCS (Newark)
State of New Jersey EMD Guidecards Version 4/06