- The Pediatric age definition has been revised to now state, 1 day to less than age 12 or less than 55 kgs in ages 12-18.
- COG 1.14 has been revised to no longer list out trauma alert criteria. Trauma alert criteria has now been replaced in appendices 12.16.
- COG 1.5 has been revised to state that the POST forms are no longer on state pilot.
- COG 2.18 has been revised and now includes anterior axillary needle decompression site.
- COG 2.23 has been updated to include current IO procedure insertion steps and considerations.
- COG 2.24 has been revised and now includes distal femur for another IO site location.
- Nitrous Oxide is no longer on state pilot and is now listed as an EMT skill procedure.
- COG 7.1 has been revised and now the defined criteria for death has been removed and now states, see COG 1.4 for criteria for death/withholding resuscitation.
- COG 8.15 has been revised to now include a Versed IM dose, if IV is unobtainable.
- COG 9.0 Pediatric Universal Airway has been created.
- Dextrose 10% dose has been increased to 5 mL/kg across all applicable pediatric protocols.
- COG 9.1 has been revised to include a ventilation rate of 20-30 breaths per minute. The defined criteria for death has been removed and now states, see COG 1.4 for criteria for death/withholding resuscitation.
- COG 9.3 has been retitled to Pediatric Post Arrest. Amiodarone drip table has been removed. Oxygenation has been revised to give supplemental oxygen to maintain SPO2 above 94%. ETCO2 target range is now listed as 35-45.
- COG 9.4 has been revised to no longer include a Amiodarone drip dose for wide complex, however now will state consider conscious sedation and synchronized cardioversion.
- COG 9.7 has been revised to include Sickle Cell Disease and less than 60 days old under immunocompromised.
- COG 9.9 has been revised to no longer state if meconium is present, intubate. Also, BVM with room air has been added in place of 100 percent oxygen. The PEARLS has also been revised to consider hypovolemia and pneumothorax if heart rate is persistently less than sixty.
- COG 9.10 has been revised to have Morphine moved up above Fentanyl in the algorithm.
- COG 9.13 has been revised to include abnormal eye movements are the most common sign of seizures in neonates.
- COG 12.6 has been revised to include an FD Medical Control consult number.
- COG 3.1 Special Team Skill Procedure Surgical Cricothyrotomy has been removed.
- COG 5.2 Adult Airway RSI, has been revised to include Age 12 or greater for indications.
- COG 8.4 Behavioral Emergencies/Chemical Restraint has been revised to include Ketamine back as a medication option. Versed also includes a 5 mg redose.
- St. Francis Downtown is moving back to a Primary Stroke Center July 1, 2021.
- Stroke, TIA (R.A.C.E score < 4) transport to GMH, Greer, SFH Downtown, SF Eastside or PMC
Behavioral Emergencies: Added repeat dose of Versed IM Removed Ketamine. This is a temporary change until we have a restock order of Ketamine.
The following revisions have been made to COG version 1.7 that was last updated in August of 2020. This COG version has been reviewed and approved by local medical control. This updated COG version will be effective on February 22nd.
- Dr. Ryan Hoffman has resigned as Assistant Medical Control Director.
- Dr. Kevin Horn has accepted the position of Assistant Medical Control Director.
- COG 1.3 has been revised to include Elderly, Children, and Vulnerable adult abuse reporting.
- COG 2.28 has been revised to include the proper procedural steps for setting up the Nitrox.
- COG 5.1 Universal Airway has been revised.
- COG 5.2 Adult Airway: MFI/RSI, has replaced COG's 5.2 and 5.3 and is now one protocol.
- COG 5.3 is now Post Airway Management. This COG has also been revised.
- COG 5.4 Adult: Failed Airway has now been created.
- COG 8.15 Sedation/Anxiety has been revised to now have a Ketamine max dose of 100 mg. Also, the procedural sedation PEARLS now only states: cardioversion and transcutaneous pacing.
- COG 8.16 Seizures has now been revised to not have max doses listed in last line of PEARLS.
- COG 8.4 has been revised to have Ketamine dose listed as mgs/kgs and the dosing chart has been removed. The upper age restrictions have also been removed for Ketamine and the PEARLS have been revised.
- COG 10.2 Burns has been revised to include further instruction for chemical burns.
- COG 10.3 Chest Injuries has been revised to state that chest seals can be done at the first responder level.
- COG 12.15 Drug list 1 has been revised to no longer include an adult dose of Acetaminophen.
- COG 12.15 Drug list 6 has been revised to include ALS and BLS Epi doses Epi IV dose has also be revised to reflect the dose listed in the guideline.
- COG 12.15 Drug list 7 has been revised to include max doses for Ketamine.
- COG 12.15 Drug list 14 has been revised to list out the Vecuronium dose.
- Version 1.7 Update Release
- Updated COVID PPE
- Updated Terbutaline
- Created new tab "Temporary Polices"
- Medication Cross Check Tab added to menu page
- Changed verbiage in PEARLS of RSI and MFI to read: Airway confirmation signature must be obtained.
- Updated Trauma Activation 1.13 to mirror current guidelines.
- misc. spellings
- removed Trauma Alert Levels, 2 & 3
- Added Telehealth guidelines
- Added Blood Administration guidelines under procedures > treatment
06.03.2020_ Updated Stroke/TIA and Hospital Designation to reflect St. Francis Hospital as a Comprehensive Stroke Center that actually went into effect 11/18/2019.
03.03.2020_Added Rocephin to Extremity Trauma/Amputation
11.5.2019_ Corrected BE Versed Dosage. Removed 2nd dose. Additional doses of Versed or Ketamine have to have online order.