Clarification to Change 2 of the PEMS Protocols

There has been some confusion regarding the recent change to the PEMS Regional Patient Care Protocols, Policies & Procedures.  This change involved two areas of the protocols:

Item 1:  The window for transport of RACE positive stroke patients was extended from 6 to 24 hours.  This change impacted the following protocols:

  • Administrative Policy: Stroke Field Triage
  • Adult Protocol: Medical – Stroke/TIA

Item 2:  In response to an anticipated shortage of Dopamine, and the large quantity of our supply expiring on 30 June, 2018, PEMS Medication Kits may not be stocked with any of this medication.  Norepinephrine (Levophed) has been added to the Medication Kits to provide an alternative medication for hypotension that is not related to trauma.  This change impacted the following protocols:

  • Adult Protocol: Medical – Hypotension/Shock (Non-Traumatic)
  • Pharmacology: Norepinephrine

Please note that Norepinephrine has only been approved for use in non-traumatic hypotension in this emergent change.  Epinephrine remains the secondary medication for treating hypotension for cardiac conditions and is also an acceptable substitute for Dopamine for non-traumatic hypotension.

Emergent changes to PEMS Regional Patient Care Protocols, Policies & Procedures are not taken lightly.  We understand that they place a significant burden on agencies and providers to provide just-in-time training to providers.  When our medical directors concur that an emergent change is necessary to provide proper care to our citizens however, we will act quickly to produce and publish the changes.  We are continuing to improve this process and we greatly appreciate the input of our constituent agencies and providers in ensuring that the final product is clear, concise and accurate.

Please update your In-Service Training curriculum to address these changes and ensure that they receive maximum distribution within your organizations.

Thank you.

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