Wfr Protocols 2012

Front 1

What are the six WFR protocols?

Back 1

1. Anaphylaxis
2. Wound Management
3. CPR
4. Spiny Injury
5. Dislocations
6. Severe Asthma

Front 2

What is the anaphylaxis protocol?

Back 2

1. Maintain an open airway and move into position of comfort. Initiate PPV or CPR if clinically indicated.
2. Inject 0.3mg dose of epinephrine into lateral muscle of thigh or deltoid muscle of shoulder.
3. Repeat injection every five minutes if needed.
4. Orally administer 25-50mg of diphenhydramine (Benadryl) every 4-6 hours.
5. Consider 40-60mg prednisone a day (as a follow up drug).
6. Watch for biphasic reaction.
7. Arrange for transport to hospital.
8. Consider an ALS intercept, if possible.
9. The patient should remain out of the field for at least 24 hours and can not return without the examining healthcare proffesional's approval.

Front 3

What is the wound management protocol?

Back 3

1. Expose the wound and apply well-aimed direct pressure to stop the bleeding.

Open Wounds:
2. Remove foreign particulate material as quickly as possible, wash surrounding skin with soap and water, and irrigate the wound with at least 100ml of drinking-quality water.
3. Irrigate high-risk wounds with large amounts of dq water under pressure, preferably using a 30 or 60cc with an 18 gauge catheter. Can also irriate with 1% povidone-iodine solution.
4. Cover the wound with a sterile bandage and immobilize high-risk wounds if possible. Do not close with sutures or butterflies.
5. Change the bandage and clean wound regularly.
6. Access need for tetanus and rabies prophylaxis. (HR wounds require rabies proph. every 5 years, all others 10.)
7. If wound was result of animal bite, assess risk of rabies exposure.

Shallow Wounds:
2. Cleanse wound with dq water or 1% PI solution.
3. Apply anti-bacterial ointment and cover with sterile, non-adhesive bandage. Immobilize wound area if possible.
4. Inspect the wound and change bandage regularly.


Impaled Objects:
- Remove all objects unless in the eye or if doing so would cause further harm.

Front 4

What is the CPR protocol? (As part of that, when are you not required to begin CPR?)

Back 4

1. Access and treat according to ILCOR CPR guidlines.
2. If cardiopulmonary arrest persists for over 30 minutes (no pulse for 30 min), all treatments may be stopped.
3. If patient recovers, support critical system function and arrange for transport to hospital. Consider ALS intercept if possible.
4. You are not obligated to begin CPR if patient has been submersed in water for over an hour with no source of air, or if they are pulseless and have a clearly lethal injury.

Front 5

What is the spine injury protocol?

Back 5

1. Assess the MOI while protecting the spine.
2. Complete a spine assessment. To rule out a spine injury, patient must meet the following critera:
- Patient is reliable (cooperative/alert/free of distracting injuries).
- Patient is free of new back or neck pain.
- Patient is free of spine pain and tenderness upon palpation.
- Patient has normal motor/sensory function in all four extremities.
3. If significant spine injury cannot be ruled out, patient should be stabilized in a safe and comfortable position in an appropriate carrying devise and transported to a hospital.

Front 6

What is the shoulder dislocation protocol?

Back 6

1. Check and document distal neurovascular function including sensation over the deltoid of affected side.
2.

Front 7

Which protocol are you allowed to perform outside of a wilderness setting?

Back 7

Anaphylaxis