N.J. Admin. Code § 8:41-7.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:41-7.5 - Standing orders for ventricular fibrillation and pulseless ventricular tachycardia

(a) The following standing orders are authorized in the event that an adult patient presents with ventricular fibrillation or pulseless ventricular tachycardia:

1. Initiate CPR;

2. Defibrillate at 200 joules or equivalent biphasic;

3. Defibrillate at 300 joules or equivalent biphasic;

4. Defibrillate at 360 joules or equivalent biphasic;

5. Assess and secure airway, oxygenate and intubate;

6. Establish IV access with normal saline solution;

7. Administer Epinephrine 1 mg IV or 2 mg ET of a 1:10,000 concentration. Repeat every three minutes to a total of three administrations, or Vasopressin 40 units IV one time only. The choice between Epinephrine or Vasopressin shall be at the discretion of the program's medical director, as confirmed by a letter to OEMS;

8. Perform CPR for one minute and defibrillate at 360 joules or equivalent biphasic;

9. Administration Lidocaine 1.5 mg/kg IV or 300 mg IV Amiodarone. The choice between Lidocaine or Amiodarone shall be at the discretion of the program's medical director, as confirmed by a letter to OEMS;

10. Perform CPR for one minute and defibrillate at 360 joules or equivalent biphasic; and

11. Contact the medical command physician.

(b) Check rhythm after each shock. Check the patient's pulse after the final shock in the sequence, or if the patient's cardiac rhythm should change. If ventricular fibrillation recurs after transiently converting to another rhythm, utilize whatever energy level was previously successful on the patient and defibrillate again.

(c) Should ventricular fibrillation recur after contact is made with the medical command physician, an ALS crewmember may deliver a shock at the energy level that was previously successful, without contacting the medical command physician, if such contact would significantly delay the delivery of the shock.

(d) In the event that an AED has been applied and utilized prior to the arrival of an ALS crewmember, the ALS crewmember shall continue the treatment protocol with regard to last energy level of defibrillation and next step in the treatment algorithm.

(e) Total amount of solutions given via ET not to exceed 50 cc.

N.J. Admin. Code § 8:41-7.5