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If the bite was from a human, if possible, ascertain the identity and medical history of the person.\u003cbr\u003e\n\u003cbr\u003e\n7.\tDo not attempt to secure animal. Leave it to Law Enforcement or Animal Control Officers. All animal bites must be reported. This will normally be done at the medical facility.\u003cbr\u003e\n\u003cbr\u003e\n8.\tTransport the patient to an appropriate medical facility.\u003cbr\u003e\n\u003cbr\u003e\n9.\tIf patient exhibits signs and symptoms of shock, follow Shock Treatment Guidelines.","adBanner":{"ad_banner_enable":0,"banner":"","redirect_url":""},"mapThirdParty":"0","MapThirdParty":"0","reviewRating":1,"attributesForList":[],"directoryInfo":[],"formIdentifier":"default","formType":"custom","widgetInfo":{"widget_enable":null,"widget_label":"Widget Label","widget_code":null},"listOwner":"","claimStatus":null,"pwaUrl":"https://www.lcfdapp.com/services_1582148118880_5/2114007/2114009/10012445"},{"listId":10040664,"catId":2114009,"dirPageId":"services_1582148118880_5","distance":"","chatUrl":"","chatType":"","verified":0,"header":"BITES (VENOMOUS)","summary":"","detail":"BITES / VENOMOUS\u003cbr\u003e\n\u003cbr\u003e\nALL LEVELS\u003cbr\u003e\n\u003cbr\u003e\nDESIGNATION OF CONDITION\u003cbr\u003e\nSigns and symptoms may include any one or all of the following: pain, local swelling, puncture wounds, bleeding at site, tachycardia, tachypnea, vomiting, abdominal pain, numbness at extremities, and headache. Rapid onset of signs and symptoms indicate a major envenomation. \u003cbr\u003e\n\u003cbr\u003e\nEMPHASIS ON PATIENT CARE\u003cbr\u003e\nScene safety, control of bleeding, prevent further contamination. Do not cut and attempt to remove poison. Do not use any type of cryotherapy on bite wound.\u003cbr\u003e\n\u003cbr\u003e\n\u003cbr\u003e\n1.\tAssess the scene for safety. Remove patient to a safe area for assessment and treatment.\u003cbr\u003e\n\u003cbr\u003e\n2.\tPrimary Management - Assess airway, breathing and circulation and manage as indicated.\u003cbr\u003e\n3.\tManage bite wound and extremity:\u003cbr\u003e\nA.\tRemove jewelry from affected limb.\u003cbr\u003e\nB.\tStabilize extremity and place at a level of the heart.\u003cbr\u003e\nC.\tImmobilize the bitten extremity\u003cbr\u003e\nD.\tIrrigate bite with sterile isotonic solution or sterile water.\u003cbr\u003e\nE.\tKeep at the level of the heart\u003cbr\u003e\n4.\tInitiate transport to an appropriate medical facility.\u003cbr\u003e\n5.\tConsider calling poison control \u003cbr\u003e\n6.\tSecondary Management - History, physical exam, vital signs\u003cbr\u003e\na.\tObtain history of bite.\u003cbr\u003e\ni.\tTry to safely identify type of animal.\u003cbr\u003e\nii.\tAscertain time of bite and onset of signs and symptoms.\u003cbr\u003e\nb.\tKeep patient calm and still.\u003cbr\u003e\n7.\tIf anaphylaxis develops, see Anaphylactic Reaction Treatment Guidelines\u003cbr\u003e\n\u003cbr\u003e\n8.\tAEMT / PARAMEDIC\u003cbr\u003e\n\u003cbr\u003e\n1.\tIn route, initiate IV/IO access in an unaffected extremity; if necessary, titrate isotonic solution to end organ perfusion determined by patient condition.\u003cbr\u003e\n\u003cbr\u003e\n2.\tTreat pain per Pain Management Protocol","adBanner":{"ad_banner_enable":0,"banner":"","redirect_url":""},"mapThirdParty":"0","MapThirdParty":"0","reviewRating":1,"attributesForList":[],"directoryInfo":[],"formIdentifier":"default","formType":"custom","widgetInfo":{"widget_enable":null,"widget_label":"Widget Label","widget_code":null},"listOwner":"","claimStatus":null,"pwaUrl":"https://www.lcfdapp.com/services_1582148118880_5/2114007/2114009/10040664"},{"listId":10040665,"catId":2114009,"dirPageId":"services_1582148118880_5","distance":"","chatUrl":"","chatType":"","verified":0,"header":"HYPERTHERMIA","summary":"","detail":"HYPERTHERMIA\u003cbr\u003e\n\u003cbr\u003e\nDESIGNATION OF CONDITION\u003cbr\u003e\n\u003cbr\u003e\nHyperthermia is considered a sustained core temperature of greater than 101° F (38.3° C), with thermoregulatory mechanisms failing around 105.8° F (41° C). This condition can result from environmental exposure, exertion, medications, or illness. Signs and symptoms include any or all of the following: muscle cramps, weakness, exhaustion, dizziness, fainting, altered level of consciousness, unresponsiveness, and rapid heart rate. Skin may be moist or dry, and normal, cool, or hot. The most severe sign of hyperthermia is an altered level of consciousness which is characteristic of Heat Stroke.\u003cbr\u003e\n\u003cbr\u003e\nEMPHASIS ON PATIENT CARE\u003cbr\u003e\n\u003cbr\u003e\nALL LEVELS:\u003cbr\u003e\n1.\tPrimary Management - Assess ABC’S and manage as indicated.\u003cbr\u003e\n\u003cbr\u003e\n2.\tRapid cooling is essential. Techniques will vary depending on level of patient’s condition: Heat Exhaustion, or Heat Stroke. Any heat related condition with an altered level of consciousness should be treated as Heat Stroke and transported after cooling on-scene.\u003cbr\u003e\na.\tMove patient to a cool, shaded area.\u003cbr\u003e\nb.\tFor simple Heat Exhaustion passive cooling methods may be effective: shade, air conditioning, ice packs, wet towels. Push fluids in Heat Exhaustion PO or IV if needed.\u003cbr\u003e\nc.\tHeat Stroke: Rapid cooling can be accomplished with 10-20 pounds of ice in a body bag with water. Place the patient in the water for 10-20 minutes until mental status improves. Patient may remain clothed during cooling. If mental status fails to improve with cooling, consider transport. Be certain to empty patient’s pockets prior to immersion.\u003cbr\u003e\n3.\tSecondary Management - History, physical exam, vital signs\u003cbr\u003e\n\u003cbr\u003e\nAEMT:\u003cbr\u003e\n\u003cbr\u003e\n1.\tEstablish an IV of NS or LR and fluid bolus to maintain adequate end organ perfusion, consider 1L fluid bolus and repeat as needed for dehydration or tachycardia. Establish a second IV at same rate if acute hyperthermia is present. \u003cbr\u003e\n2.\tIf nausea and vomiting present treat with Ondansetron (Zofran) 4 mg PO (ODT)/IV\u003cbr\u003e\nPARAMEDIC:\u003cbr\u003e\n\u003cbr\u003e\n1.\tApply cardiac monitor; treat lethal dysrhythmias concurrently\u003cbr\u003e\n\u003cbr\u003e\nNotes:\u003cbr\u003e\n\u003cbr\u003e\nExtremes of age are more prone to heat emergencies. Obtain and document patient temperature if able. Predisposed by use of: TCA anti-depressants, phenothiazines, anticholinergic medications and alcohol. Cocaine, amphetamines, and salicylates may elevate body temperature. Sweating generally disappears as body temperature rises above 104 F (40C) rectally. Intense shivering may occur as patient is cooled. \u003cbr\u003e\n\u003cbr\u003e\nHeat exhaustion consists of dehydration, salt depletion, dizziness, fever, headache, cramping, nausea and vomiting. Vital signs usually consist of tachycardia, hypotension and elevated temperature. Heat stroke typically consists of dehydration, dry skin, red skin, tachycardia, hypotension, temperature \u003e 104 F (40 C) rectally and AMS.\u003cbr\u003e\n\u003cbr\u003e\nNon-rectal temperature measurements are inaccurate and only estimate body temperature.\u003cbr\u003e\n\u003cbr\u003e\n\u003cbr\u003e\nSymptoms\u003cbr\u003e\nHeat Exhaustion\tHeat Stroke\u003cbr\u003e\nNormal mental status\tClammy skin\tAMS\tDilated pupils\u003cbr\u003e\nThready pulse\tMuscle cramps/ spasms\tHot, dry skin (\u003c25% is moist)\tTachycardia\u003cbr\u003e\nSlightly elevated temperature\tDizziness\tTemperature often \u003e104 F (40 C)\t\u003cbr\u003e\nNausea / Vomiting\tMuscle cramps / spasms\tArrhythmias\t\u003cbr\u003e\n\u003cbr\u003e\nSpecial Note: In rare Exertional Heat Stroke cases rapid cooling on scene is advisable like in classic Heat Stroke. Findings consist of rectal temperature greater than 104.5, altered mental status, profuse sweating, and physical exertion in a hot environment. Rapid cooling can be accomplished with 10-20 pounds of ice in a body bag with water. Place the patient in the water for 10-20 minutes until mental status improves. Patient may remain clothed during cooling. Be certain to empty patient’s pockets prior to immersion. If mental status fails to improve with cooling, consider transport. Patients with exertional heat stroke should be evaluated in an emergency department.","adBanner":{"ad_banner_enable":0,"banner":"","redirect_url":""},"mapThirdParty":"0","MapThirdParty":"0","reviewRating":1,"attributesForList":[],"directoryInfo":[],"formIdentifier":"default","formType":"custom","widgetInfo":{"widget_enable":0,"widget_label":"Widget Label","widget_code":""},"listOwner":"","claimStatus":null,"pwaUrl":"https://www.lcfdapp.com/services_1582148118880_5/2114007/2114009/10040665"},{"listId":10040666,"catId":2114009,"dirPageId":"services_1582148118880_5","distance":"","chatUrl":"","chatType":"","verified":0,"header":"HYPOTHERMIA","summary":"","detail":"HYPOTHERMIA\u003cbr\u003e\nALL LEVELS\u003cbr\u003e\nDESIGNATION OF CONDITION\u003cbr\u003e\nMild hypothermia: core body temperature is between 94° and 97° F (34-36° C). Moderate hypothermia: core body temperature 86 and 94° F (30-34° C). Patients with mild to moderate hypothermia may exhibit signs and symptoms of shivering, tachycardia, tachypnea, decreasing LOC, lethargic (may be fully oriented), and loss of fine motor coordination. Severe hypothermia: core temperature \u003c 86° F (30° C) with signs and symptoms of pupil dilation, bradycardia, bradypnea, coma, no shivering, arrhythmia, and joint stiffness.\u003cbr\u003e\nTo change Celsius to Fahrenheit: 1.8 x C + 32 (example: 30 c * 1.8 + 32 = 86oF) EMPHASIS ON PATIENT CARE\u003cbr\u003e\nMaintenance of body heat, airway management. LOC is the most reliable indicator of the severity of hypothermia.\u003cbr\u003e\n\u003cbr\u003e\n1.\tPrimary Management- Assess ABC’s and manage as indicated.\u003cbr\u003e\n\u003cbr\u003e\n2.\tRemove patient from the environment.\u003cbr\u003e\n\u003cbr\u003e\n3.\tRemove all wet clothing.\u003cbr\u003e\n\u003cbr\u003e\n4.\tSecondary Management - History, physical exam, vital signs\u003cbr\u003e\n\u003cbr\u003e\n5.\tManaging mild to moderate hypothermia.\u003cbr\u003e\n\u003cbr\u003e\na.\tAdminister warmed, humidified oxygen titrated to patient condition.\u003cbr\u003e\n\u003cbr\u003e\nb.\tIf patient becomes hypoxic, administer oxygen and/or assist ventilations as needed.\u003cbr\u003e\n\u003cbr\u003e\n6.\tAvoid rough handling when moving the patient.\u003cbr\u003e\n\u003cbr\u003e\n7.\tCover with blankets, preferably warmed.\u003cbr\u003e\n\u003cbr\u003e\n8.\tMonitor the patient’s vital signs and rhythm closely. \u003cbr\u003e\n\u003cbr\u003e\n9.\tTransport the patient to appropriate medical facility.\u003cbr\u003e\n\u003cbr\u003e\nAEMT\u003cbr\u003e\n\u003cbr\u003e\n1.\tIn-route, initiate a large bore IV/IO of warm/tepid isotonic solution and infuse at a rate to maintain adequate end organ. In severe hypothermia IV fluid administration should be done with caution to avoid after-drop effect of circulating acidotic/toxic peripheral blood to the heart and brain.\u003cbr\u003e\n \u003cbr\u003e\n\u003cbr\u003e\nHYPOTHERMIA\u003cbr\u003e\nPARAMEDIC\u003cbr\u003e\n\u003cbr\u003e\n1.\tAirway management should be limited to basic manual procedures and slow ventilatory assistance. If unable to manage the airway by basic maneuvers, adjuncts may be used, however this may induce ventricular dysrhythmias and overzealous ventilatory assistance can induce hypocapnia, resulting in ventricular irritability.\u003cbr\u003e\n\u003cbr\u003e\n2.\tIf ventricular arrhythmia develops may attempt defibrillation once.\u003cbr\u003e\n\u003cbr\u003e\n3.\tSubsequent defibrillations or additional cardiac life support medications should be avoided until the patient has been re-warmed in the emergency department. Warm the patient’s core first to avoid after-drop effect. Ventilating patient via mouth to mask may be the most effective core warming device available pre-hospital.","adBanner":{"ad_banner_enable":0,"banner":"","redirect_url":""},"mapThirdParty":"0","MapThirdParty":"0","reviewRating":1,"attributesForList":[],"directoryInfo":[],"formIdentifier":"default","formType":"custom","widgetInfo":{"widget_enable":null,"widget_label":"Widget Label","widget_code":null},"listOwner":"","claimStatus":null,"pwaUrl":"https://www.lcfdapp.com/services_1582148118880_5/2114007/2114009/10040666"},{"listId":10040663,"catId":2114009,"dirPageId":"services_1582148118880_5","distance":"","chatUrl":"","chatType":"","verified":0,"header":"NEAR DROWNING","summary":"","detail":"NEAR DROWNING\u003cbr\u003e\n\u003cbr\u003e\nALL LEVELS\u003cbr\u003e\n\u003cbr\u003e\nDESIGNATION OF CONDITION\u003cbr\u003e\nIncludes a history of being submerged under water for an excessive period of time resulting in potential cardiopulmonary compromise. Mitigating circumstances include shockable rhythm, inconclusive history of immersion, uncertain water temperature.\u003cbr\u003e\n\u003cbr\u003e\nEMPHASIS ON PATIENT CARE\u003cbr\u003e\n\u003cbr\u003e\n1.\tPrimary Management - Assess ABC’s and manage as indicated. \u003cbr\u003e\n2.\tBegin artificial respirations in the water, taking C-spine precautions. Stabilize C-spine prior to moving from water if any suspicion of a potential head or neck injury exists.\u003cbr\u003e\n3.\tIf hypothermia is present or suspected, refer to Hypothermia Treatment Guidelines.\u003cbr\u003e\n4.\tIf water temperature is \u003c 6°C (43°F) and submerged;\u003cbr\u003e\na.\t\u003c90 minutes: full resuscitation\u003cbr\u003e\nb.\t\u003e90 minutes: do not initiate resuscitation unless mitigating circumstances\u003cbr\u003e\n5.\tIf water temperature is \u003e6°C (43°F) and submerged:\u003cbr\u003e\na.\t\u003c30 minutes: initiate full resuscitation\u003cbr\u003e\nb.\t\u003e30 minutes: do not initiate resuscitation unless mitigating circumstances\u003cbr\u003e\n6.\tSecondary Management - History, physical exam, vital signs\u003cbr\u003e\na.\tHistory of incident including:\u003cbr\u003e\ni.\tHow long was patient submerged?\u003cbr\u003e\nii.\tFresh, polluted or salt water\u003cbr\u003e\niii.\tDiving accident (suspect C-spine injury)\u003cbr\u003e\niv.\tWater temperature\u003cbr\u003e\nv.\tPre-existing medical conditions\u003cbr\u003e\nAEMT\u003cbr\u003e\n1.\tIn-route, initiate a large bore IV/IO of an isotonic solution and infuse at a flow rate to maintain adequate end organ perfusion.\u003cbr\u003e\n2.\tIf cardiac arrest occurs, follow Medical Cardiac Arrest Treatment Guidelines.\u003cbr\u003e\n\u003cbr\u003e\nPARAMEDIC\u003cbr\u003e\n1.\tECG monitor \u003cbr\u003e\n2.\tMonitor patients' vital signs and continue to reassess\u003cbr\u003e\n3.\tTransport to appropriate facility","adBanner":{"ad_banner_enable":0,"banner":"","redirect_url":""},"mapThirdParty":"0","MapThirdParty":"0","reviewRating":1,"attributesForList":[],"directoryInfo":[],"formIdentifier":"default","formType":"custom","widgetInfo":{"widget_enable":null,"widget_label":"Widget Label","widget_code":null},"listOwner":"","claimStatus":null,"pwaUrl":"https://www.lcfdapp.com/services_1582148118880_5/2114007/2114009/10040663"}],"data":false,"categoryData":{"catName":"ENVIRONMENTAL","catId":2114009,"catIcon":""},"parentCategoryData":{"catId":2114007,"catName":"GUIDELINES"}},"match":{"hostname":"www.lcfdapp.com","page":"services_1582148118880_5","category":"2114009"}}},"page":"/[...slug]","query":{"slug":["services_1582148118880_5/2114009"]},"buildId":"1234567890","isFallback":false,"dynamicIds":[1204],"customServer":true,"gip":true,"scriptLoader":[]}