About SNHD Protocols
EMS Protocols for Paramedic's in Clark County, Nevada. This is the full version of the SNHD Protocols manual for Paramedics/EMT's in the Clark County area. Included in this is the Field Reference Guide, a Map of...
EMS Protocols for Paramedic's in Clark County, Nevada.
This is the full version of the SNHD Protocols manual for Paramedics/EMT's in the Clark County area. Included in this is the Field Reference Guide, a Map of Hospitals, and a List of Hospitals that provides directions.
Feb 18, 2024
Version 1.31
Manual Updates for January, 2024:
1.EMTs can now pursue an EMT-IV endorsement after completing the mandatory training. The agency must agree to 100% chart review, and this skill may only be performed under the supervision of a paramedic or AEMT. The EMT can only perform the skill and is not allowed to be the primary caregiver for the patient.
2. Trauma Field Triage Criteria has been updated to follow the latest guidelines approved by the American College of Surgeons Commitee on Trauma. Instead of Steps, there are now Red and Yellow categories. Catchment for Sunrise and Siena have remained the same. There have been some adjustments made to Mike O’Callaghan catchment.
3. Adult Cardiac Arrest pearls were updated to allow for the use of mechanical CPR devices on pregnant patients if these devices were approved for this use by their manufacturer. CPR is to follow a pit crew approach, with roles assigned prior to arrival whenever possible.
4. Westcare has been removed as a patient destination.
5. MountainView Hospital has been removed as a NIR capable facility.
6. Dopamine has been removed from all protocols, as well as from the EMS formulary.
7. Removal of Push Dose Phenylephrine from the Adult Bradycardia protocol.
8. Addition of Push Dose Epinephrine to the Adult Bradycardia and Pediatric Shock protocols.
9. The dosage of Push Dose Epinephrine was standardized across all adult protocols to 10 mcg IV/IO.
10. The dosage of Push Dose Epinephrine in pediatric protocols standardized to 0.1 mcg/kg IV/IO, max 5 mcg.
11. CPAP procedure protocol name changed to Non-Invasive Positive Pressure Ventilation to allow for the use of both ventilators equipped for Bi-Pap and masks that can be dual utilized for CPAP and Bi-level ventilation.
12. Sodium bicarbonate dosage in Adult Hyperkalemia and Adult Overdose protocols changed to 50 meq IV/IO. Sodium Bicarbonate dosage in Pediatric Overdose protocol changed to 1/meq/kg, max 50 mg. The notation of using 4.2% for neonates was removed from the front of the protocol and added as a pearl. Both adult and pediatric overdose protocols will allow for a repeat dose if the QRS remains wide after treatment.
13. Atropine dosage in Adult Bradycardia changed to 1mg to align with current ACLS standards.
14. Updated Behavioral Emergencies protocol, removing the “excited delirium” language and stressing the avoidance of placing agitated patients in the prone position.
15. Removal of Push Dose Phenylephrine from cardiogenic shock on the Shock protocol. Replaced with Push dose epinephrine.
16. Name of Needle Thoracentesis protocol changed to Needle Decompression, and more detail added to mid-axillary placement directions.
17. Changes in terminology in the Behavioral Emergencies protocol including emphasis on patient positioning while restrained.
Previous Versions
Here you can find the changelog of SNHD Protocols since it was posted on our website on 2016-10-02 16:50:48.
The latest version is 1.31 and it was updated on 2024-04-22 10:56:18. See below the changes in each version.
SNHD Protocols version 1.31
Updated At: 2024-02-18
Changes: Feb 18, 2024
Version 1.31
Manual Updates for January, 2024:
1.EMTs can now pursue an EMT-IV endorsement after completing the mandatory training. The agency must agree to 100% chart review, and this skill may only be performed under the supervision of a paramedic or AEMT. The EMT can only perform the skill and is not allowed to be the primary caregiver for the patient.
2. Trauma Field Triage Criteria has been updated to follow the latest guidelines approved by the American College of Surgeons Commitee on Trauma. Instead of Steps, there are now Red and Yellow categories. Catchment for Sunrise and Siena have remained the same. There have been some adjustments made to Mike O’Callaghan catchment.
3. Adult Cardiac Arrest pearls were updated to allow for the use of mechanical CPR devices on pregnant patients if these devices were approved for this use by their manufacturer. CPR is to follow a pit crew approach, with roles assigned prior to arrival whenever possible.
4. Westcare has been removed as a patient destination.
5. MountainView Hospital has been removed as a NIR capable facility.
6. Dopamine has been removed from all protocols, as well as from the EMS formulary.
7. Removal of Push Dose Phenylephrine from the Adult Bradycardia protocol.
8. Addition of Push Dose Epinephrine to the Adult Bradycardia and Pediatric Shock protocols.
9. The dosage of Push Dose Epinephrine was standardized across all adult protocols to 10 mcg IV/IO.
10. The dosage of Push Dose Epinephrine in pediatric protocols standardized to 0.1 mcg/kg IV/IO, max 5 mcg.
11. CPAP procedure protocol name changed to Non-Invasive Positive Pressure Ventilation to allow for the use of both ventilators equipped for Bi-Pap and masks that can be dual utilized for CPAP and Bi-level ventilation.
12. Sodium bicarbonate dosage in Adult Hyperkalemia and Adult Overdose protocols changed to 50 meq IV/IO. Sodium Bicarbonate dosage in Pediatric Overdose protocol changed to 1/meq/kg, max 50 mg. The notation of using 4.2% for neonates was removed from the front of the protocol and added as a pearl. Both adult and pediatric overdose protocols will allow for a repeat dose if the QRS remains wide after treatment.
13. Atropine dosage in Adult Bradycardia changed to 1mg to align with current ACLS standards.
14. Updated Behavioral Emergencies protocol, removing the “excited delirium” language and stressing the avoidance of placing agitated patients in the prone position.
15. Removal of Push Dose Phenylephrine from cardiogenic shock on the Shock protocol. Replaced with Push dose epinephrine.
16. Name of Needle Thoracentesis protocol changed to Needle Decompression, and more detail added to mid-axillary placement directions.
17. Changes in terminology in the Behavioral Emergencies protocol including emphasis on patient positioning while restrained.
SNHD Protocols version 1.30
Updated At: 2023-06-26
Changes: Jun 26, 2023
Version 1.30
Protocol updates for June 2023.
SNHD Protocols version 1.29
Updated At: 2023-02-27
Changes: Feb 27, 2023
Version 1.29
-Updates for February 2023
-Fixed the CPAP chapter.
SNHD Protocols version 1.24
Updated At: 2022-03-05
Changes: Mar 5, 2022 Version 1.24
-Updates to to the Protocols Manual (January, 2022)
-New Hospitals added to the Map List
SNHD Protocols version 1.23
Updated At: 2021-08-15
Changes: Aug 15, 2021 Version 1.23
Updated Protocols for July 2021. New Hospitals added to the Map and List.
SNHD Protocols version 1.22
Updated At: 2021-07-14
Changes: Jul 14, 2021 Version 1.22
More Door Codes have been added to the Hospital Numbers Chapter in the Field Reference Guide.
New Manual Version Added.
SNHD Protocols version 1.20
Updated At: 2020-04-17
Changes: Apr 17, 2020 Version 1.20
Glasgow Coma Scale has been fixed. Some chapters have been removed.
SNHD Protocols version 1.19
Updated At: 2020-04-15
Changes: Apr 15, 2020 Version 1.19
Fixed the Glasgow Coma Scale chapter. Also new are chapters and a tab for responding to COVID-19:
-COVID Protocol and Packet
-Respiratory Distress For Use Only During COVID Response
-MDI Addition to Inventory
-Terbutaline Formulary
SNHD Protocols version 1.18
Updated At: 2020-04-13
Changes: Apr 13, 2020 Version 1.18
Added chapters and a tab for responding to COVID-19:
-COVID Protocol and Packet
-Respiratory Distress For Use Only During COVID Response
-MDI Addition to Inventory
-Terbutaline Formulary
SNHD Protocols version 1.17
Updated At: 2020-03-02
Changes: Mar 2, 2020 Version 1.17
New in this Version: Changes in the Protocols:
Adult Protocol Changes:
-Sepsis (Suspected) (MAB 12-4-19) – Added a new protocol providing guidelines for recognition and
treatment of suspected sepsis.
-Termination of Resuscitation (MAB 8-7-2019) – Removed capnography requirement under medical arrest. Now reads “for medical arrest: The Patient remains in persistent asystole or agonal rhythm after twneyt (20 minutes of appropriate Paramedic resuscitation to include:...”
-Transport Destinations (MAB 10-2-2019) – Remote Outpatient Emergency Department Alternate Destination Criteria. Revised line 2 to read “The patient has normal vital signs, unless accepted by the remote outpatient emergency department, telemetry contact is made, and ...”
-Addition of Page D3 – Addition of Telemetry Radio Map.
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