Central Region EMS Guidelines - Overview of 2025 Changes

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Central Regional EMS Guidelines (CAREMSG) Updates for 2025

1. Guidelines moved to General Medical section from General Policies

a. Universal Care

b. Pediatric Assessment Triangle

c. Functional Needs

d. Informed Consent/Non-Treatment/Non-Transport

e. Abuse and Maltreatment

f. Pain Management

g. Update TOC and hyperlinks

2. Universal Care

a. Added “continuously” to assess scene safety

3. Informed Consent/Non-Treatment/Non-Transport

a. Added “Patient Refusal” to title

b. Request from field to facilitate finding guideline

4. Pain Management

a. Ketamine – updated dosing parameters for when to repeat

b. New verbiage: Ketamine 0.25mg/kg IV/IO, max per dose 25mg, may repeat every 20 minutes, max total dose 100mg

5. Hypoglycemia

a. Current version lists weight-based oral glucose dose

b. Changed to Glucose 15-25g PO, may repeat X1 as needed (only if alert and able to swallow) – for both Adult & Pediatric patients

i. Added clarifying language for oral glucose (only if alert and able to swallow)

c. Removed duplicate language

6. Chest Pain/STEMI

a. Added “for pain” before administer Nitro

b. Risk for hypotension with SL NTG

c. Should not treat EKG findings

Regional EMS Guidelines (CAREMSG) Updates for 2025

7. Bradycardia

a. Updated language about when to perform Transcutaneous Pacing (TCP) versus going straight to OHCA guideline

i. Bradycardia +hemodynamic instability + unconscious/unresponsive = go to OHCA guideline

ii. Bradycardia + shock + conscious = TCP + Push dose Epi

iii. Bradycardia + symptoms without shock + conscious = Push dose Epi or Atropine

b. Updated Pharmacologic Management when performing Transcutaneous Pacing (TCP)

c. Removed Benzos due to risk of hypotension, respiratory compromise, and neuro depression

d. Added Fentanyl, along with hyperlink to Pharmacologic Management guideline in appendix

8. Tachycardia

a. Torsades

i. Updated Magnesium dose to be weight based, 50 mg/kg, max 2g

9. Cardiac Arrest

a. Cardiac Arrest flow sheet deleted for consistency of format and outdated verbiage

b. Updated dose for Calcium Chloride – field request

10. ROSC guideline

a. Under bradycardia – removed line referencing TCP, refer to Bradycardia guideline

11. Neonatal Resuscitation

a. Removed 2nd page: AAP Neonatal algorithm

b. Deleted due to conflicting information compared to our guidelines

c. Updated TOC to delete this page

d. Clarified that this only applies to newborns, refer to Cardiac Arrest Adult & Pediatric for all other neonatal patients

12. Childbirth

a. Moved section about placenta and postpartum hemorrhage to EMT section

Central Regional EMS Guidelines (CAREMSG) Updates for 2025

13. Calcium Chloride Dosing (4 guidelines)

a. Hyperglycemia

b. Cardiac Arrest

c. Extremity Trauma

d. Dermal Chemical Burns

14. Agitated or Violent Patient

a. Request to add “Combative” to the title for ease of finding guideline

b. Added hyperlink to link Restraint guideline

c. Clarified language regarding in- custody patients and LE ride-in

15. Restraint guideline

a. Clarified language regarding in- custody patients and LE ride-in

16. Crashing Medical Patient guideline

a. New guideline added

b. Other EMS systems have seen improved outcomes with on scene stabilization of critical medical patients prior to transport

17. Bites and Envenomations

a. Added Push dose Epi per request

b. Added bear to pediatric dosing

18. Facility Name and Phone Number Updates

a. HonorHealth Florence Medical Center

b. HonorHealth Mountain Vista Medical Center

c. HonorHealth Mesa Emergency Center

d. HonorHealth Tempe Medical Center

19. Anaphylaxis

a. Hyperlink to abnormal VS not working

20. Others?

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