Happy Monday!
We are implementing the IV Nitroglycerin (via PUMP ONLY) Pilot protocol in Washington County for patients exhibiting severe acute pulmonary edema/CHF . If your units do not currently carry an IV pump and your patient meets the indications, please call for your nearest EMS supervisor unit and continue your SL and transdermal routes of Nitro as normal until the supervisor’s arrival. Do not delay the administration of SL and transdermal NTG.
For those clinicians that did not recertify this year and therefore did not attend the ALS skills sessions, the following resources and training have been provided and is required to be reviewed:
Nitroglyerin protocol attached : please note that we are NOT participating in the IV bolus portion of the protocol. Nitroglyerin IVPump flowchart attached – ***Please note that there is an additional step in our jurisdictional flow chart: the lower limit systolic blood pressure. Please familiarize yourself with this flowchart and how to calculate the target systolic blood pressure as well as the lower limit systolic blood pressure.
You tube video presentation: https://www.youtube.com/watch?v=nyK1kYSoSmU
For EMS supervisors, the pumps have been programmed for Nitroglycerine infusion. Please review your pump and equipment that has been added to your units. (or will be today) The IV pump tubing will need to be vented for use with a glass bottle. (see the video)
Any questions or clarifications needed, please let me know!
If you were not in ALS skills session this year, Please respond to this email that you have reviewed the protocol, the flow chart, and have watched the youtube video.
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375
We are implementing the IV Nitroglycerin (via PUMP ONLY) Pilot protocol in Washington County for patients exhibiting severe acute pulmonary edema/CHF . If your units do not currently carry an IV pump and your patient meets the indications, please call for your nearest EMS supervisor unit and continue your SL and transdermal routes of Nitro as normal until the supervisor’s arrival. Do not delay the administration of SL and transdermal NTG.
For those clinicians that did not recertify this year and therefore did not attend the ALS skills sessions, the following resources and training have been provided and is required to be reviewed:
Nitroglyerin protocol attached : please note that we are NOT participating in the IV bolus portion of the protocol. Nitroglyerin IVPump flowchart attached – ***Please note that there is an additional step in our jurisdictional flow chart: the lower limit systolic blood pressure. Please familiarize yourself with this flowchart and how to calculate the target systolic blood pressure as well as the lower limit systolic blood pressure.
You tube video presentation: https://www.youtube.com/watch?v=nyK1kYSoSmU
For EMS supervisors, the pumps have been programmed for Nitroglycerine infusion. Please review your pump and equipment that has been added to your units. (or will be today) The IV pump tubing will need to be vented for use with a glass bottle. (see the video)
Any questions or clarifications needed, please let me know!
If you were not in ALS skills session this year, Please respond to this email that you have reviewed the protocol, the flow chart, and have watched the youtube video.
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 301-491-2454 (office) 240-313-4376 (fax) 240-313-4375
IV-nitro-Pilot-Protocol.pdf
IVP-nitro-flow-chart.docx