| Airway |
Intubate → Ventilation tidal volume @ 6-8 mL/kg |
|
Place OG or NG tube |
|
Confirm endotracheal and OG/NG tube placement with chest x-ray |
| Breathing |
SpO2 goal >94% → adjust PEEP & FiO2 to achieve goal |
|
EtCO2 goal 30-40 mmHg → adjust respiratory rate to achieve |
| Circulation |
12-lead ECG → Activate cardiac catheterization lab for STEMI; consult cardiology for all other patients |
|
SBP goal >90 mmHg (MAP > 65 mmHg) → Use fluids, norepinephrine infusion, then epinephrine infusion to achieve goal |
|
Place central line |
|
Place arterial line |
|
Perform point of care ultrasound with the cardiac, lung, and IVC views |
|
Send labs, which includes an arterial blood gas and serum lactate |
|
Place Foley catheter → Goal urine output 0.5-1 mL/kg/hr |
|
Consider CT chest angiography to rule-out a pulmonary embolism |
| Disability |
Begin cooling → Goal temperature 32–36°C |
|
Consider head CT |
