SOG 430

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Jbrand
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91518
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SOG 430
Updated:
2011-06-26 21:17:53
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SOG
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SOG 430
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  1. BOEMS
    Bureau of EMS
  2. PERSONNEL DISCOVERING AN ABANDONED NEONATE SHALL:
    • ASSESS
    • NOTIFY LAW ENFORCEMENT AGENCY
    • TRANSPORT
  3. PARENTS MAY LEAVE BEHIND INFORMATION REGARDING MEDICAL AND SOCIAL HISTORY REGARDING THE NEW BORN.
    ATTEMPT TO:
    IF ANY WRITTEN INFORMATION AVAILABLE:
    • OBTAIN AND RECORD THIS HISTORY
    • BRING WITH PATIENT TO NEAREST APPROPRIATE RECEIVING FACILITY
  4. A PATIENT SHALL BE DEFINED AS: A PERSON WHO PRESENTS WITH __________ OR __________
    • SUBJECTIVE AND/OR OBJECTIVE SIGNS AND/OR SYMPTOMS
    • A COMPLAINT WHICH RESULTS IN EVALUATION AND/OR TREATMENT
  5. A PATIENT ENCOUNTER IS DEPENDENT ON NEITHER ______; IF A TECHNICIAN PERCEIVES A _______, A PATIENT ENCOUNTER HAS BEEN MADE.
    ________ NO COMPLAINT EXISTS AND THERE ARE NO SUBJECTIVE OR OBJECTIVE SIGNS AND/OR SYMPTOMS
    • TREATMENT NOR TRANSPORT NOR COOPERATION FROM THE PATIENT
    • MEDICAL PROBLEM THAT REQUIRES EVALUATION
    • THIS EXCLUDES TIMES WHERE
  6. A PATIENT IS CONSIDERED TO GIVE INFORMED CONSENT WHEN ANY OF THE FOLLOWING OCCUR:
    • VERBAL PERMISSION TO TREAT
    • WRITTEN PERMISSION TO TREAT
    • NOT OBJECT AS YOU BEGIN ASSESSMENT
  7. IN ORDER TO GIVE INFORMED CONSENT A PATIENT MUST BE MENTALLY COMPETENT. THIS MEANS THE PATIENT MUST BE:
    • AWAKE, ALERT, AND FULLY ORIENTED TO PERSON, PLACE, TIME AND SITUATION
    • NO SIGNIFICANT METAIL IMPAIRMENT (ALCOHOL, HEAD INJURY OR SIGNIFICANT ILLNESS)
    • NOT SUICIDAL OR HOMICIDAL AND DOES NOT WANT TO HURT THEMSELVES
  8. IMPLIED CONSENT
    EXAMINATION, TREATMENT, AND TRANSPORT MAY BE INITIATED WITHOUT INFORMED CONSENT FROM THE PATIENT, IF ALL FOUR OF THE FOLLOWING CONDITIONS ARE MET:
    • THE PATIENT IS INTOXICATED, UNDER THE INFLUENCE OF DRUGS OR INCAPABLE OF PROVIDING INFORMED CONSENT
    • EMERGENCY MEDICAL CONDITION
    • COMPENTENT PATIENT WOULD NORMALLY GIVE CONSENT
    • UNREASONABLE FORCE SHALL NOT BE USED
  9. CRITERIA FOR IMPLIED CONSENT IS
    • IMMEDIATE LIFE SAVING CARE IS INDICATED
    • UNCONSCIOUS AND/OR UNABLE TO GIVE INFORMED CONSENT
    • CASES OF CHILDREN OR ADULTS AND PARENT OR LEGAL GUARDIAN IS NOT AVAILABLE
  10. IMPLIED CONSENT
    IF MEDICAL PERSONNEL ARE CONCERNED FOR THE SAFETY OF A MINOR AND THE LEGAL GUARDIAN AS DEFINIED BELOW REFUSES TRANSPORT:
    CONTACT
    • MEDICAL CONTROL FOR ASSISTANCE WITH CONVINCING GUARDIAN
    • LOCAL POLICE FOR ASSISTANCE WITH TRANSPORT
  11. BAKER ACT
    INVOLUNTARY MENTAL HEALTH COMMITMENT
  12. MYERS ACT
    INVOLUNTARY COMMITMENT FOR SUBSTANCE ABUSE
  13. IF ANY CIRCUMSTANCE PROHIBITS THE EMT OR PARAMEDIC FROM GIVING NEEDED EMERGENCY SERVICE
    • REQUEST POLICE FOR BAKER OR MYERS ACT, IF NEEDED
    • CONTACT THE RESCUE DISTRICT/BATTALION CHIEF
  14. PATIENTS IN POLICE CUSTODY
    ANY DISCREPANCIES BETWEEN JFRD TRANSPORT PROTOCOL AND LAW ENFORCEMENT'S DESTINATION DECISION WILL BE DIRECTED TO THE
    APPROPRIATE DISTRICT/BATTALION CHIEF
  15. TASER DEPLOYMENT
    TREAT AS HIGH INDEX OF SUSPICION WARRANTING FURTHER ASSESSMENT AND SHALL INCLUDE:
    PAY CLOSE ATTENTION TO:
    • -BASIC NUEROLOGICAL EXAMINATION
    • -SKINS SIGNS
    • -PUPIL ASSESSMENT
    • -COMPLETE SET OF VITAL SIGNS AND EXAMINATION FOR TRAUMATIC INJURIES
    • -CHEST PAIN
    • -SHORTNESS OF BREATH
    • -VOMITING
    • -INCONTINENCE
    • -HEADACHE

    • -CARDIAC HISTORY
    • -CARDIAC ARTERY DISEASE
    • -MYOCARDIAL INFARCTION
    • -CONGESTIVE HEART FAILURE
  16. DO NOT REMOVE TASER PROBES WHEN IMPLANTED IN SENSITIVE AREAS. TREAT AS AN IMPALED OBJECT AND TRANSPORT PATIENT TO THE HOSPITAL:
    • FACE
    • THROAT
    • EYE
    • GROIN
    • BREAST
    • HANDS
    • FEET
  17. PATIENTS WHO HAVE BEEN TASED SHOULD BE TRANSPORTED FOR
    • HISTORY OF DELIRIUM, MANIA, OR IRRATIONAL BIZARRE BEHAVIOR BEFORE BEING TASED
    • PERSISTENT ABNORMAL VITAL SIGNS
    • HISTORY OR PRESENT USE OF AMPHETAMINE OR HALLUCINOGENIC DRUG USE
    • CARDIAC HISTORY
    • ALTERED LEVEL OF CONSCIOUSNESS
    • AGGRESSIVE BEHAVIOR INCLUDING RESISTANCE TO EVALUATION
    • EVIDENCE OF HYPERTHERMIA
    • ABNORMAL SUBJECTIVE COMPLAINTS
    • -CHEST PAIN
    • -SHORTNESS OF BREATH
    • -NAUSEA OR HEADACHES
  18. PATIENT RESTRAINT
    PHYSICAL RESTRAINTS ARE PERMITTED FOR PATIENTS WHO ARE AT IMMEDIATE RISK FOR HARMING THEMSELVES OR OTHERS BECAUSE OF IMPAIRED JUDGEMENT DUE TO ANY COMBINATION OF THE FOLLOWING:
    • DRUGS AND/OR ALCOHOL
    • PSYCHIATRIC ILLNESS
    • HEAD INJURY
    • MEATABOLIC CAUSES (CNS INFECTION, HYPOGLYCEMIA, ETC.)
    • DEMENTIA
  19. CARE OF RESTRAINED PATIENTS
    POSITION OF RESTRAINED PATIENT
    • SUPINE
    • FOWLER'S
    • SEMI-FOWLER'S
  20. CARE OF RESTRAINED PATIENT
    FREQUENTLY ASSESS THE RESTRAINED PATIENT TO ENSURE
    • PATENT AIRWAY
    • DISTAL LIMB CIRCULATION EVERY 10 MINUTES
    • RESTRAINTS CAN BE RELEASED QUICKLY
  21. IDENTIFYING EXCITED DELIRIUM
    PHYSICAL SIGNS OF EXCITED DELIRIUM INCLUDE:
    • UNFOUNDED FEAR AND PANIC
    • SHOUTING/NONSENSICAL SPEECH
    • BIZARRE BEHAVIOR
    • HYPERACTIVITY AND THRASHING ABOUT
    • UNEXPLAINED STRENGTH/ENDURANCE
    • NUDITY
    • PROFUSE DIAPHORESIS
  22. EXCITED DELIRIUM CAN MIMIC SEVERAL MEDICAL CONDITIONS
    • HYPOXIA
    • HYPOGLYCEMIA
    • STROKE
    • INTRACRANIAL BLEEDING
  23. SUSPICION OF ABUSE
    WHEN JFRD SUSPECT THE ABUSE/NEGLECT HAS TAKEN PLACE THEY SHALL INITIATE THE FOLLOWING:
    • TREAT RELATED INJURIES AND TRANSPORT ALL SUSPECTED CASES
    • IN TRANSPORT REFUSED:
    • -REQUEST LAW ENFORCEMENT AT SCENE
    • -STAY WITH PATIENT UNTIL LAW ENFORCEMENT ARRIVAL
    • -NOTIFY THE RESCUE DISTRICT/BATTALION CHIEF
  24. UNQUESTIONABLE DEATH CRITERIA
    PATIENTS MEETING THE FOLLOWING CRITERIA SHALL BE CONSIDERED FOR DOS:
    • UNRESPONSIVE
    • APNEIC
    • PULSELESS
  25. UNQUESTIONABLE DEATH CRITERIA
    IN ADDITION TO THE ABOVE, THE PATIENT SHALL MEET AT LEAST ONE OF THE FOLLOWING CRITERIA:
    • LIVIDITY
    • CLEAR SIGNS OF BODY DECAY OR VISIBLE DECOMPOSITION
    • RIGOR MORTIS
    • OPEN CRANIUM WITH EXPOSED BRAIN MATTER
    • DECAPITATED OR HAS A SEVERED TRUNK
    • MULTI-SYSTEM TRAUMA PATIENT
    • THE ASYSTOLIC TRAUMA PATIENT DOES NOT NEED TO HAVE A COLD BODY TEMPERATURE
  26. BLUNT CHEST TRAUMA PATIENTS MEETING THE FOLLOWING CRITERIA SHALL BE CONSIDERED DOS:
    • UNRESPONSIVE
    • APNEIC
    • PULSELESS
    • NO HEART SOUNDS OR CARDIAC ACTIVITY ON THE MONITOR CONFIRMED IN TWO LEADS
    • WIDE COMPLEX VENTRICULAR RHYTHM OF 30 OR LESS WITHOUT A PULSE
  27. RESUSCITATION PROTOCOL
    WHEN LAW ENFORCEMENT OR JFRD PERSONNEL HAVE DETERMINED THE SCENE IS A DEATH SCENE THE FOLLOWING STEPS SHOULD BE TAKEN FOR CONTROL:
    • IF LAW ENFORCEMENT IS NOT PRESENT, NOTIFY THEM
    • IF LAW ENFORCEMENT IS ON-SCENE, FOLLOW THEIR DIRECTIONS
  28. FAMILY, FRIENDS OR OTHER PASSENGERS WILL NOT BE ROUTINELY TRANSPORTED UNLESS REQUIRED FOR THE CONTINUATION OF PATIENT CARE. EXAMPLES:
    • PEDIATRIC PATIENTS REQUIRING A PARENT OR GUARDIAN
    • GERIATRIC PATIENTS REQUIRING A GUARDIAN OR CAREGIVER
    • PATIENTS WITH LANGUAGE BARRIERS REQUIRING A TRANSLATOR
    • PATIENTS WITH SPEECH DISABILITIES REQUIRING SOMEONE PROFICIENT IN SIGN LANGUAGE
  29. IF PATIENT NOT ASSESSED BY MEDICAL STAFF WITHIN 15 MINUTES OF ARRIVAL
    CONSULT WITH CHARGE NURSE OR NURSE MANAGER FOR GUIDANCE
  30. WMD/BIOTERRORISM
    THE HEALTH DEPARTMENT _________________________ RESCUE DISTRICT/BATTALION CHIEF
    WILL BE CONSULTED FOR ALL TRANSPORT DECISIONS AND DESTINATIONS INVOLVING THESE TYPES OF INCIDENTS. THE FINAL AUTHORITY FOR ALL TRANSPORT DECISIONS WILL LIE WITH THE
  31. STANDARD PRECAUTIONS WILL BE PRACTICED BY EMS PERSONNEL CARING FOR PATIENTS WITH POTENTIALLY TRANSMISSIBLE INFECTIONS INCLUDING:
    • HAND WASHING (BEFORE AND AFTER PATIENT CONTACT)
    • WEARING DISPOSABLE GLOVES
    • WEARING MASKS WITH EYE PROTECTION OR FACE SHIELDS
    • WEARING PROTECTIVE GOWNS
  32. ANTHRAX IS AN ACUTE INFECTIOUS DISEASE CAUSED BY
    BACILLUS ANTHRACIS, A SPORE-FORMING, GRAM-POSITIVE BACILLUS
  33. ________ form of botulism is also possible, but unlikey.
    inhalational
  34. NON-SUSPECTED CRIME SCENE
    UNQUESTIONABLE DEATH CRITERIA
    • CANCEL ALS RESPONSE
    • IF A COMPETENT ADULT IS ON-SCENE, THE COMPANY MAY RETURN TO SERVICE, IF LAW ENFORCEMENT RESPONSE WILL BE PROLONGED. THIS OPTION IS AT THE DISCRETION OF THE COMPANY OFFICER BASED ON THE CIRCUMSTANCES PRESENT AND SHALL BE PROPERLY DOCUMENTED.
  35. MASK AND EYE SHIELDS SHOULD BE USED FOR
    • INTUBATION OR OTHER AIRWAY MANEUVERS
    • RISK OF CONTACT WITH BODY FLUIDS TO MUCOUS MEMBRANES
  36. GOWNS AND ARM SHIELDS SHOULD BE USED WHEN
    HANDLING PATIENTS THAT GENERATE INCREASED RISK FOR CONTACT WITH BODY FLUIDS
  37. ALL RE-USABLE EQUIPMENT SHOULD BE THOROUGHLY DISINFECTED AFTER USE BY
    • WASH WITH SOAP AND WATER
    • CLEANSE WITH APPROPRIATE DISINFECTING AGENT
    • DRY THOROUGHLY BEOFRE RETURNING TO STORAGE
  38. SHARPS ARE
    THE MOST COMMON FORM OF CONTAMINATION HAZARD TO THE HEALTH CARE PROVIDER
  39. TRANSPORTATION AND DESTINATION MUST BE DETERMINED BY UNIFORM GUIDELINES FROM SPECIFIC PROTOCOLS AND FREE FROM THE INFLUENCE OF
    ABILITY TO PAY, SOCIAL STATUS, CONVENIENCE OF ATTENDANTS, OR OTHER DISCRIMINATION FACTORS
  40. THE FOLLOWING SITUATIONS WILL REQUIRE TRANSPORT OF THE PATIENT TO THE HOSPITAL BY RESCUE
    • CHEST OR ABDOMINAL PAIN IN THE ADULT PATIENT
    • DYSPNEA (SHORTNESS OF BREATH)
    • ALL NEAR-DROWNINGS
    • CONDITIONS THAT MIGHT BE EXACERBATED BY IMPROPER HANDLING OR INAPPROPRIATE TRANSPORT
  41. THE JFRD NON-EMERGENCY/NON-TRANSPORT PROTCOL WILL BE FOLLOWED FOR
    ALL PATIENTS REFERRED FOR OTHER FORMS OF TRANSPORT OR CARE (NOT PRIVATE AMBULANCE)
  42. THE OFFICER-IN-CHARGE WILL DETERMINE THE TRANSPORT DESTINATION AFTER CONSIDERING THE FOLLOWING
    • LIFE THREATENING CONDITIONS OR UNSTABLE
    • STABLE PATIENTS -USUALLY SEEN AND WHERE THERE MEDICAL RECORDS ARE
  43. A HOSPITAL'S ABILITY TO PROVIDE SPECIALIZED CARE, IF KNOWN, SHOULD BE CONSIDERED
    • AVAILABILITY OF NEUROSURGERY
    • OB/GYN CAPABILITY
    • OPERATING ROOM AVAILABILITY
    • SPECIALIZED DIAGNOSTIC CAPABILITY
    • MENTAL HEALTH CARE CAPABILITIES
  44. FOR EACH EMS CALL, (FRCC) SHALL OBTAIN THE FOLLOWING INFORMATION
    • ADDRESS OR LOCATION OF THE INCIDENT
    • NATURE OF EMERGENCY
    • -NUMBER OF PATIENTS
    • -TYPE AND SEVERITY OF INJURY(S)
    • TYPE OF LOCATION
    • COMPLAINANT'S NAME AND PHONE NUMBER
  45. WHEN THE OFFICER-IN-CHARGE OF SCENE DEEMS THAT RAPID TRANSPORT IS NECESSARY CONSIDER
    AN ATU
  46. A TRAUMA ALERT PATIENT MAY BE TRANSPORTED TO A RECEIVING FACILITY OTHER THAN A SATC OR SAPTRC UNDER THE FOLLOWING CONDITIONS:
    • IMPRACTICAL DUE TO UNFORESEEN EVENTS
    • AFTER INFORMING STATE GUIDELINES, PATIENT STILL INSISTS ANOTHER FACILITY, TRANSPORT WILL PROCEED ACCORDING TO PATIENT'S WISHES
    • LIFE MAY BE ENDANGERED IF CARE IS DELAYED

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