Читать книгу Emergency Medical Services - Группа авторов - Страница 269

When developing protocols, focus on the simple data and steps. For example, both the bradycardia and tachycardia protocols should start with a division between “stable/no symptoms” and “symptomatic and unstable or borderline.” Those in the “stable/no symptoms” category should be observed, expeditiously transported, and monitored, with precautionary IV insertion and, if needed, oxygen. As a corollary, unstable patients with bradycardia or tachycardia should receive prompt electrical therapy (pacing or countershock), airway support, monitoring, and IV insertion occurring either in tandem with or after electrical therapy. EMS clinicians should save rhythm strips and give sedation if possible, but not withhold lifesaving treatment trying to “get a good strip” or titrating sedation. Unless the signs of instability are subtle, medical oversight contact should follow the initial treatment of unstable patients.