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==TABLE OF CONTENTS==
==TABLE OF CONTENTS==
[[Medical Director Authorization]]
===Section 1 - Administrative Policies===
===Section 1 - Administrative Policies===
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date !! Reviewed Date
|-
| 1.01 || [[General Measures]] || March-24 ||March-24
|-
| 1.02 || [[Radio Report Format]] || July-21 ||
|-
| 1.03 || [[Refusal of Service]] || October-17 ||
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09 ||
|-
|-
| 1.01 || [[General Measures]] || March-09
| 1.05 || [[Initiation of CPR and Determination of Death]] || July-16 ||
|-
|-
| 1.02 || [[Radio Report Format]] || March-09
| 1.06|| [[Determination of Death in Trauma]]|| March-09 ||
|-
|-
| 1.03 || [[Refusal of Service]] || March-09
| 1.07|| [[Crime or Unattended Death Scene]] || March-09 ||
|-
|-
| 1.04 || [[Physician or Nurse on Scene]] || March-09
| 1.08|| [[Medical Evaluation of Person in Police Custody]]|| March-09 ||
|-
|-
| 1.05 || [[Initiation of CPR and Determination of Death]] || March-09
| 1.09|| [[Trauma Transport Protocol]]|| February-19 ||
|-
|-
| 1.06|| [[Determination of Death in Trauma]]|| March-09
| 1.10|| [[Emergency Transport]]|| March-09 ||
|-
|-
| 1.07|| [[Crime or Unattended Death Scene]] || March-09
| 1.11|| [[Criteria for Helicopter Transport]]|| March-09 ||
|-
|-
| 1.08|| [[Medical Evaluation of Person in Police Custody]]|| March-09
| 1.12|| [[Medical Patient Transport Decision]]|| April-14 ||
|-
|-
| 1.09|| [[Trauma Transport Protocol]]|| March-09
| 1.13|| [[Obstetrical Patient Transport Decision]]|| October-20 ||
|-
|-
| 1.10|| [[Emergency Transport]]|| March-09
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09 ||
|-
|-
| 1.11|| [[Criteria for Helicopter Transport]]|| March-09
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 ||
|-
|-
| 1.12|| [[Medical Patient Transport Decision]]|| March-09
| 1.16|| [[EMS Offload Policy]]|| March-09 ||
|-
|-
| 1.13|| [[Obstetrical Patient Transport Decision]]|| March-09
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| July-23 ||
|-
|-
| 1.14|| [[Emergency Inter Facility Transport]]|| March-09
| 1.18|| [[EMS Quality Improvement Program]]|| March-09 ||
|-
|-
| 1.15|| [[EMS Saturation Disaster Response Levels]]|| March-09
| 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 ||
|-
|-
| 1.16|| [[EMS Offload Policy]]|| March-09
| 1.20|| [[Scope of Practice]]|| July-23 ||
|-
|-
| 1.17|| [[EMT and Paramedic County Certification Procedure]]|| Jan-10
| 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 ||
|-
|-
| 1.18|| [[EMS Quality Improvement Program]]|| March-09
| 1.22|| [[Hospital Capability Chart - DRAFT|Hospital Capability Chart]]|| May-24 ||May-24
|-
|-
| 1.19|| [[HIV Post Exposure Prophylaxis (PEP)]]|| March-09
| 1.23|| [[Documentation Guidance]]|| June-24 ||June-24
|-
|-
| 1.20|| [[Scope of Practice]]|| March-09
| 1.24|| [[School Medication Authorization Forms]]|| June-18 ||
 
|}
|}


===Section 2 - Primary Care===
===Section 2 - Primary Care===
{| class="wikitable"
{| class="wikitable"
|-
|-
Line 53: Line 68:
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
| 2.01 ||[[Initial Medical Assessment and Care]]||March-09
|-
|-
|2.02 ||[[Initial Trauma Assessment and Care]]||March-09
|2.02 ||[[Initial Trauma Assessment and Care]]||September-17
|-
|-
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||March-09
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15
|-
|-
||2.04||[[Analgesia and Sedation]]||March-09
||2.04||[[Analgesia and Sedation]]||December-20
|-
||2.05||[[Drug Assisted Intubation]]||December-16
|}
|}


===Section 3 - Respiratory===
===Section 3 - Respiratory===
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date
|-
|-
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| March-09
| 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19
|-
|-
| 3.02|| [[Carbon Monoxide Inhalation]]|| March-09
| 3.02|| [[Carbon Monoxide Inhalation]]|| June-19
|-
|-
| 3.03|| [[Foreign Body Airway Obstruction]]|| March-09
| 3.03|| [[Foreign Body Airway Obstruction]]|| October-24
|-
|-
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| March-09
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| April-16
|-
|-
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
| 3.05|| [[Severe Respiratory Pathogens]]|| November-10
|-
| 3.06|| [[Anxiety or Hyperventilation]]|| February-11
|}
|}


===Section 4 - Cardiac===
===Section 4 - Cardiac===
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date
|-
|-
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||March-09
|4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22
|-
|-
|4.02 || [[Asystole]]||March-09
|4.02 || [[Asystole]]||December-22
|-
|-
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||March-09
|4.03 || [[Atrial Fibrillation Atrial Flutter]]||April-20
|-
|-
|4.04||[[Pulsesless Electrical Activity (PEA)]]||March-09
|4.04||[[Pulseless Electrical Activity (PEA)]]||January-16
|-
|-
|4.05||[[Premature Ventricular Contractions (PVC)]]||March-09
|4.05||[[Premature Ventricular Contractions (PVC)]]||May-12
|-
|-
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||March-09
|4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24
|-
|-
|4.07||[[Supraventricular Tachycardia]]||March-09
|4.07||[[Supraventricular Tachycardia]]||January-20
|-
|-
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||March-09
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16
|-
|-
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||March-09
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12
|-
|-
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||March-09
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]||January-20
|-
|-
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|4.11||[[Acute Cardiogenic Pulmonary Edema Pneumonia]]||March-09
|-
|-
|4.12||[[Code Cool Post ROSC Induced Hypothermia]]||March-09
|4.12||[[Code Cool Post ROSC Induced Hypothermia]]||March-09
|-
|4.13||[[Adult Immediate Post-Cardiac Arrest Care]]||April-12
|-
|4.14||[[Ventricular Assist Devices]]||March-22
|}
|}


===section 5- Medical===
===Section 5 - Medical===
 
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date
|-
|-
|5.01||[[Acute Abdominal Pain]]||March-09
|5.01||[[Acute Abdominal Pain]]||April-16
|-
|-
|5.02||[[Allergic Reaction Anaphylactic Shock]]||March-09
|5.02||[[Allergic Reaction Anaphylactic Shock]]||March-19
|-
|-
|5.03||[[Altered Mental Status (AMS)]]||March-09
|5.03||[[Altered Mental Status (AMS)]]||April-17
|-
|-
|5.04||[[Suspected Stroke Transcient Ischemic Attack TIA]]||March-09
|5.04||[[Suspected Stroke Transcient Ischemic Attack TIA|Suspected Stroke or Transcient Ischemic Attack]]||May-24
|-
|-
|5.05||[[Drug Overdose Poisoning]]||March-09
|5.05||[[Drug Overdose Poisoning]]||March-09
|-
|-
|5.06||[[Environmental Cold Emergencies]]||March-09
|5.06||[[Cold Emergencies]]||April-12
|-
|-
|5.07||[[Environmental Heat Emergencies]]||March-09
|5.07||[[Heat Emergencies]]||August-15
|-
|-
|5.08||[[Hazardous Materials]]||March-09
|5.08||[[Hazardous Materials]]||July-22
|-
|-
|5.09||[[Severe Hypertension]]||March-09
|5.09||[[Severe Hypertension]]||March-09
|-
|-
|5.10||[[Hypo or Hyperglycemia]]||March-09
|5.10||[[Hypo or Hyperglycemia]]||April-16
|-
|-
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|5.11||[[Psychological Behavioral Emergencies]]||March-09
|-
|-
|5.12||[[Seizure]]||March-09
|5.12||[[Seizure]]||April-16
|-
|-
|5.13||[[Shock]]||March-09
|5.13||[[Non-Hemorrhagic Shock]]||October-18
|-
|-
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
|5.14||[[Sickle Cell Anemia Crisis]]||March-09
Line 143: Line 169:
|5.16||[[Vertigo]]||March-09
|5.16||[[Vertigo]]||March-09
|-
|-
|5.17||[[Sepsis Septic Shock]]||March-09
|5.17||[[Sepsis Septic Shock]]||Jan-24
|-
|5.18||[[Suspected Kidney Stone]]||April-16
|-
|5.19||[[Cyanide Poisoning]]||April-16
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November-17
|-
|-
|5.18||[[Suspected Kidney Stone]]||March-09
|5.21||[[Ebola Virus Disease Patient Management]]||October-14
|-
|-
|5.19||[[Cyanide Poisoning]]||April-09
|5.22||[[Acute Adrenal Insufficiency]]||June-18
|-
|-
|5.20||[[Excited Delirium or Drug Induced Agitation]]||November -10
|5.23
|[[CORE Opioid Addiction Recovery]]
|October-24
|}
|}


===Section 6 - Trauma===
===Section 6 - Trauma===
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date
|-
|-
|6.01||[[Animal Bites Stings]]||March-09
|6.01||[[Animal Bites Stings]]||August-18
|-
|-
|6.02||[[Burns - Thermal, Electrical, Chemical]]||March-09
|6.02||[[Burns - Thermal, Electrical, Chemical]]||March-09
|-
|-
|6.03||[[Selective Spinal Immobilization]]||March-09
|6.03||[[Selective Spinal Immobilization]]||August-14
|-
|-
|6.04||[[Chest Injuries]]||March-09
|6.04||[[Chest Injuries]]||March-09
Line 167: Line 202:
|6.05||[[Decompression Sickness or Dysbarism]]||March-09
|6.05||[[Decompression Sickness or Dysbarism]]||March-09
|-
|-
|6.06||[[Extremity Injuries]]||March-09
|6.06||[[Extremity Injuries]]||January-24
|-
|-
|6.07||[[Head Injuries]]||March-09
|6.07||[[Head Injuries]]||September-24
|-
|-
|6.08||[[Near Drowning]]||March-09
|6.08||[[Near Drowning]]||March-09
Line 178: Line 213:
|-
|-
|6.11||[[Suspected Sexual Assault]]||March-09
|6.11||[[Suspected Sexual Assault]]||March-09
|-
|6.12||[[Trunk Penetrating Injuries]]||January-24
|-
|6.13||[[Hemorrhagic Shock]]||October-18
|}
|}


===Section 7 - Pediatric and Obstetrical===
===Section 7 - Pediatric and Obstetrical===
{| class="wikitable"
{| class="wikitable"
|-
|-
! Section !! Description !! Revision Date
! Section !! Description !! Revision Date
|-
|-
|7.01||[[Pediatric Asystole]]||March-09
|7.01||[[Pediatric Asystole]]||April-16
|-
|-
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||March-09
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16
|-
|-
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||March-09
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16
|-
|-
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||March-09
|7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20
|-
|-
|7.05||[[Preterm Labor]]||March-09
|7.05||[[Preterm Labor]]||November-17
|-
|-
|7.06||[[Emergency Childbirth]]||March-09
|7.06||[[Emergency Childbirth]]||November-17
|-
|-
|7.07||[[Childbirth Complications]]||March-09
|7.07||[[Childbirth Complications]]||November-17
|-
|-
|7.08||[[Newborn Care]]||March-09
|7.08||[[Newborn Care]]||April-16
|-
|-
|7.09||[[Post Partum Care]]||March-09
|7.09||[[Post Partum Care]]||November-17
|-
|-
|7.10||[[Pediatric Febrile Emergency]]||March-09
|7.10||[[Pediatric Febrile Emergency]]||April-16
|-
|-
|7.11||[[Vaginal Bleeding]]||March-09
|7.11||[[Vaginal Bleeding]]||March-09
Line 209: Line 249:
|7.12||[[Trauma In Pregnancy]]||March-09
|7.12||[[Trauma In Pregnancy]]||March-09
|}
|}
===Section 8 - Medication Guidelines===
INTRODUCTION
The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.
Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.
The following medications are authorized to be administered by Seminole County EMS:
{| class="wikitable"
|-
! Medication Name!! Revision Date
|-
|[[Acetaminophen]]||March-09
|-
|[[Adenosine]]||January-20
|-
|[[Albuterol]]||April-16
|-
|[[Amiodarone]]||July-17
|-
|[[Ancef]]||January-24
|-
|[[Aspirin]]||March-09
|-
|[[Atropine]]||July-17
|-
|[[Atrovent]]||April-16
|-
|[[Calcium Chloride]]||April-16
|-
|[[Cardizem]]||July-17
|-
|[[Cyanokit]]||April-16
|-
|[[Dextrose 10%]]||April-16
|-
|[[Dextrose 50%]]||April-16
|-
|[[Diphenhydramine]]||April-16
|-
|[[Dopamine]]||April-16
|-
|[[Epinephrine]]||April-16
|-
|[[Flumazenil]]||April-16
|-
|[[Geodon]]||April-16
|-
|[[Glucagon]]||April-16
|-
|[[Hypertonic Saline|Hypertonic (3%) Saline]]||September-24
|-
|[[Keppra]]||September-24
|-
|[[Ketamine]]||November-20
|-
|[[Lasix]]||April-16
|-
|[[Lidocaine]]||July-17
|-
|[[Magnesium Sulfate]]||April-16
|-
|[[Morphine Sulfate]]||November-16
|-
|[[Naloxone]]||April-16
|-
|[[Nitro Drip]]||April-17
|-
|[[Nitro Spray]]||April-17
|-
|[[Nitro Tablets]]||April-17
|-
|[[Nitrous Oxide]]||November-16
|-
|[[Oxygen]]||March-09
|-
|[[Pepcid]]||April-16
|-
|[[Pontocaine]]||November-17
|-
|[[Promethazine]]||April-16
|-
|[[Racemic Epinephrine]]||April-16
|-
|[[Sodium Bicarbonate]]||April-16
|-
|[[Solu-Medrol]]||January-17
|-
|[[Toradol]]||August-24
|-
|[[TXA]]||October-20
|-
|[[Xopenex]]||April-16
|-
|[[Valium]]||April-16
|-
|[[Versed]]||April-16
|-
|[[Zofran]]||April-16
|-
|[[Medication Infusion Tables]]||March-09
|}
===Section 9 - Procedure Guidelines===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|9.00||[[Lucas Device]]||November-21
|-
|9.01||[[Autovent]]||March-09
|-
|9.02||[[Blood Alcohol Draw on Scene]]||March-18
|-
|9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||March-09
|-
|9.04||[[Blood Glucose Test]]||March-09
|-
|9.05||[[Buretrol Usage]]||March-09
|-
|9.06||[[Cardiac Monitor]]||April-12
|-
|9.07||[[Cardioversion]]||March-09
|-
|9.08||[[Continuous Positive Airway Pressure Device]]||March-09
|-
|9.09||[[Cricothyrotomy Needle]]||March-09
|-
|9.10||[[Cricothyrotomy Surgical]]||March-09
|-
|9.11||[[Defibrillation]]||March-09
|-
|9.12||[[Defibrillation Pediatric]]||March-09
|-
|9.13||[[End Tidal CO2 Monitoring and Capnography]]||March-09
|-
|9.14.1||[[Intraosseous Infusion - Femoral]]||February-15
|-
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16
|-
|9.15||[[Intubation Endotracheal]]||March-09
|-
|9.16||[[Intubation Nasotracheal]]||March-09
|-
|9.17||[[IVAC Medsystem III MultiChannel Infusion Pump]]||March-09
|-
|9.18||[[King Tube]]||March-09
|-
|9.19||[[Medication Administration Intramuscular]]||March-09
|-
|9.20||[[Medication Administration Nasal Atomizer]]||March-09
|-
|9.21||[[Medication Administration Nebulizer]]||March-09
|-
|9.22||[[Medication Administration Subcutaneous]]||March-09
|-
|9.23||[[Nasogastric/Orogastric Tube]]||March-09
|-
|9.24||[[Oxygen Administration]]||March-09
|-
|9.25||[[Peripheral IV Administration]]||March-09
|-
|9.26||[[Pleural Decompression]]||March-09
|-
|9.27||[[Removal of Taser Probes]]||March-09
|-
|9.28||[[Reconstitution of Medications]]||March-09
|-
|9.29||[[ResQPOD Impedance Threshold Device]]||March-09
|-
|9.30||[[Transcutaneous Pacing Procedure]]||March-09
|-
|9.31||[[ResQGuard Impedance Threshold Device]]||April-11
|-
|9.32||[[Emergency Escharotomy|Emergency Chest Wall Escharotomy]]||April-11
|-
|9.33||[[Venous Lactate Monitoring Procedure]]||May-12
|-
|9.34||[[Central Venous Access Devices]]||June-12
|-
|9.35||[[Medication Administration Cross Check]]||Jun-12
|-
|9.36||[[Combat Application Tourniquet]]||Jan-14
|-
|9.37||[http://lifevest.zoll.com/medical-professionals/first-responder-resources Zoll LifeVest Wearable Defibrillator]||Dec-14
|-
|9.38||[[iTClamp Hemorrhage Control System]]||Feb-15
|-
|9.39||[[I-gel Supraglottic Airway]]||February-24
|-
|9.40||[[T-POD Pelvic Stabilization Device]]||Sept-23
|-
|9.41||[[Controlled Substance Disposal Procedures]]||Mar-24
|-
|9.42||[[LifeVac]]||Oct-24
|}
===Section 10 - References===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|10.01||[[Abbreviations]]||March-09
|-
|10.02||[[Apgar Score]]||March-09
|-
|10.03||[[Glasgow Coma Score]]||March-09
|-
|10.04||[[Pediatric Vital Signs]]||March-09
|-
|10.05||[[Adult Trauma Alert Criteria]]||March-09
|-
|10.06||[[Pediatric Trauma Alert Criteria]]||March-09
|-
|10.07||[[Pediatric Trauma Score]]||March-09
|-
|10.08||[[Nitroglycerin Drip]]||March-09
|-
|10.09||[[Checking Range of Motion]]||March-09
|-
|10.10||[https://www.health.state.mn.us/communities/ep/surge/burn/tbsa.html Rule of Nines]||March-09
|-
|10.11||[[Florida Statutes]]||March-09
|-
|10.12||[[Evaluation and Treatment Flow Chart]]||March-09
|-
|10.13||[[Spinal Injury Assessment Critical Criteria]]||March-09
|-
|10.14||[[Celox Gauze Powerpoint]]||April-12
|-
|10.15||[[Sepsis and Venous Lactate Powerpoint]]||April-12
|-
|10.16||[[Media:MCSO EMS LVAD Guide.pdf| LVAD EMS Guide]]||Sept-18
|-
|10.16.1||[[Media:LVAD HeartmateIII Green.pdf| HeartMate III LVAD - Green]]||Sept-18
|-
|10.16.2||[[Media:LVAD HeartmateII Red.pdf| HeartMate II LVAD - Red]]||Sept-18
|-
|10.16.3||[[Media:LVAD HeartWare DarkBlue.pdf| HeartWare LVAD - Dark Blue]]||Sept-18
|-
|10.16.4||[[Media:LVAD Jarvik Lavender.pdf| Jarvik 2000 LVAD - Lavendar]]||Sept-18
|-
|10.16.5||[[Media:LVAD Thoratec LightBlue.pdf| Thoratec LVAD - Light Blue]]||Sept-18
|-
|10.16.6||[[Media:LVAD DuraHeart Purple.pdf| DuraHeart LVAD - Purple]]||Sept-18
|-
|10.16.7||[[Media:LVAD TotalArtificialHeart Pink.pdf| Total Artificial Heart LVAD - Pink]]||Sept-18
|}
===Section 11 - Medical Director Memos===
{| class="wikitable sortable"
|-
! Subject !! Effective Date
|-
| [[Memo - Hurricane Ian – EMS OPERATIONS]]|| 2022-09-28
|-
| [[Memo - Masks Required in ED's]]|| 2022-08-22
|-
| [[Memo - QA/QI Program]]|| 2022-03-21
|-
| [[Memo - Additional EMS Skills]]|| 2020-09-01
|-
| [[Memo - Transport of SEPSIS Patients to Freestanding ED's]]|| 2020-07-15
|-
| [[Memo - Clarification on Destination Choices|Clarification on Destination Choices]]|| 2019-11-14
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte Clarification|Transport to the OD Hospital – Advent Health Altamonte Clarification]]|| 2019-11-07
|-
| [[Memo - Transport to the OD Hospital – Advent Health Altamonte|Transport to the OD Hospital – Advent Health Altamonte]]|| 2019-11-04
|-
| [[Memo - Further clarification on Advent Health OD Facility|Further clarification on Advent Health OD Facility]]|| 2019-08-26
|-
| [[Memo - Transporting of Overdose Patients to AdventHealth Altamonte|Transporting of Overdose Patients to AdventHealth Altamonte]]|| 2019-08-12
|-
| [[Memo - EMS Reports on Lift Assists|EMS Reports on Lift Assists]]|| 2019-03-01
|-
| [[Memo - Blood Draws - Nurses refusing tubes|Blood Draws - Nurses refusing tubes]]|| 2018-08-23
|-
| [[Memo - Clarification of Baker Act patients transported by EMS|Clarification of Baker Act patients transported by EMS]] || 2018-04-11
|-
| [[Memo - Opening of Oviedo Medical Center|Opening of Oviedo Medical Center]] || 2017-01-29
|-
| [[Memo - Blood Draws - Florida Hospital|Blood Draws - Florida Hospital]] || 2017-01-25
|-
| [[Memo - Medical Alerts|Medical Alerts]] || 2016-04-27
|-
| [[Memo - Florida Hospital East Pediatric ED|Florida Hospital East Pediatric ED]] || 2015-11-23
|-
| [[Memo - Discontinuation of Central Venous Access|Discontinuation of Central Venous Access]] || 2013-08-03
|-
| [[Memo - Shortage of Atropine|Shortage of Atropine]] || 2013-04-11
|-
| [[Memo - EMS Blood Draws for SSCH|EMS Blood Draws for SSCH]] || 2013-03-07
|-
| [[Memo - Respiratory Breathing Treatments|Respiratory/Breathing Treatments]] || 2012-12-19
|-
| [[Memo - OB Transports|OB Transports]] || 2011-01-14
|-
| [[Memo - Aspirin Administration Documentation|Aspirin Administration Documentation]] || 2010-12-01
|-
| [[Memo - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17
|-
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06
|-
| [[Memo - Transport of STEMI Patients - Revised 20100219|Transport of STEMI Patients ]] || 2010-03-19
|-
| [[Memo - Aircare Update 20100319|Aircare Update ]] || 2010-03-19
|-
| [[Memo - Delayed Offloads with Critical or Unstable Patients|Delayed Offloads with Critical or Unstable Patients]] || 2010-02-25
|-
| [[Memo - Transport of STEMI Patients|Transport of STEMI Patients]] || 2010-02-19
|-
| [[Memo - Response to Physician's Offices|Response to Physicians Offices]] || 2009-10-14
|-
| [[Memo - Patient Reports Being Given to Hospitals|Patient Reports Being Given to Hospitals]] || 2009-09-23
|-
| [[Memo - Patient Medications - Revised 20090720|Patient Medications ]]|| 2009-07-20
|-
| [[Memo - H1N1 Update 20090624|H1N1 Update ]]|| 2009-06-24
|-
| [[Memo - Multiple Patient Refusal - Wording|Multiple Patient Refusal - Wording]] || 2009-06-04
|-
| [[Memo - Request for Call Reviews|Request for Call Reviews]]|| 2009-05-14
|-
| [[Memo - H1N1 Update 20090505|H1N1 Update ]] || 2009-05-05
|-
| [[Memo - Clarification on Selection for Spinal Immobilization|Clarification on Selection for Spinal Immobilization]] || 2009-04-30
|-
| [[Memo - EKG Strips|EKG Strips]]|| 2009-04-23
|-
| [[Memo - Patient Medications|Patient Medications]]|| 2009-04-23
|-
| [[Memo - Leaving run reports at the E.R.|Leaving run reports at the E.R.]] || 2009-02-03
|-
| [[Memo - Hyperbaric Chamber at CFRH|Hyperbaric Chamber at CFRH]] || 2008-10-16
|-
| [[Memo - Stemi Transport Destinations|Stemi Transport Destinations]] || 2008-07-22
|-
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04
|-
| [[Memo - Documentation of Medications|Documentation of Medications]]|| 2005-01-27
|}
===Section 12 - Paramedic Clinical Assessment Program===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
|12.01||[[Media:PCAP Guidelines Document Jan 2019.pdf|PCAP Guidelines]]||Jan-19
|-
|12.02||[[Media:ALS Contact Form Rev 2010.pdf|ALS Contact Form]]||June-10
|-
|12.03||[[Media:Evaluation Form Equip.pdf|Evaluation Form - Equip]]||Jan-13
|-
|12.04||[[Media:Evaluation Form Protocols.pdf|Evaluation Form - Protocols]]||Jan-13
|-
|12.05||[[Media:Definition of an ALS contact.pdf|ALS Contact Definition]]||June-10
|-
|12.06||[[Media:Daily Performance Evaluation Report Form.pdf|Daily Performance Eval]]||Sept-17
|-
|12.07||[[Media:Medical director meetings roster.pdf|MD Meetings Roster]]||May-13
|-
|12.08||[[Media:Mentor evaluation.pdf|Mentor Evaluation]]||May-13
|-
|12.09||[[Media:Verification of EMT Skills edited final.pdf|Verification of EMT Skills]]||May-13
|-
|12.10||[[Media:PCAP Completion Checklist.pdf|PCAP Completion Checklist]]||Sept-17
|-
|12.11||[[Media:Verification of PM Skills.pdf|Verification of Paramedic Skills]]||May-13
|-
|12.12||[[Media:ALS Contact Form Example 1.pdf|ALS Contact Form Example 1]]||Dec-14
|-
|12.13||[[Media:ALS Contact Form Example 2.pdf|ALS Contact Form Example 2]]||Dec-14
|-
|12.14||[[Media:Incapacitated Patient Management.pdf|Incapacitated Patient Management]]||Dec-14
|}
===Section 13 - COVID-19===
{| class="wikitable"
|-
! Section !! Description !! Revision Date
|-
| 13.01|| [[MD Memo - Please use Common Sense]]|| 2020-03-13
|-
| 13.02|| [[Hospital Screening and Procedures]]|| 2020-03-26
|-
| 13.03|| [[Dispatch Screening and Procedures]]|| 2020-04-01
|-
| 13.04|| [[Media:SRP Question Card.pdf| Strict Respiratory Precautions Question Card]]|| 2020-04-01
|-
| 13.05|| [[American Red Cross Changed Response Procedures]]|| 2020-03-31
|-
| 13.06|| [[Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice]] || 2020-07-15
|-
| 13.07|| [[Updated COVID Transport to FSED]]|| 2020-07-20
|}
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Latest revision as of 19:51, 22 October 2024

TABLE OF CONTENTS

Medical Director Authorization

Section 1 - Administrative Policies

Section Description Revision Date Reviewed Date
1.01 General Measures March-24 March-24
1.02 Radio Report Format July-21
1.03 Refusal of Service October-17
1.04 Physician or Nurse on Scene March-09
1.05 Initiation of CPR and Determination of Death July-16
1.06 Determination of Death in Trauma March-09
1.07 Crime or Unattended Death Scene March-09
1.08 Medical Evaluation of Person in Police Custody March-09
1.09 Trauma Transport Protocol February-19
1.10 Emergency Transport March-09
1.11 Criteria for Helicopter Transport March-09
1.12 Medical Patient Transport Decision April-14
1.13 Obstetrical Patient Transport Decision October-20
1.14 Emergency Inter Facility Transport March-09
1.15 EMS Saturation Disaster Response Levels April-16
1.16 EMS Offload Policy March-09
1.17 EMT and Paramedic County Certification Procedure July-23
1.18 EMS Quality Improvement Program March-09
1.19 Post Exposure Prophylaxis (PEP) November-21
1.20 Scope of Practice July-23
1.21 Freestanding ED Transport Criteria April-23
1.22 Hospital Capability Chart May-24 May-24
1.23 Documentation Guidance June-24 June-24
1.24 School Medication Authorization Forms June-18

Section 2 - Primary Care

Section Description Revision Date
2.01 Initial Medical Assessment and Care March-09
2.02 Initial Trauma Assessment and Care September-17
2.03 Rapid Trauma Assessment, Focused History and Physical Exam Sept-15
2.04 Analgesia and Sedation December-20
2.05 Drug Assisted Intubation December-16

Section 3 - Respiratory

Section Description Revision Date
3.01 Acute Asthma or COPD with Wheezing February-19
3.02 Carbon Monoxide Inhalation June-19
3.03 Foreign Body Airway Obstruction October-24
3.04 Infectious Upper Airway Obstruction - Croup or Epiglottitis April-16
3.05 Severe Respiratory Pathogens November-10
3.06 Anxiety or Hyperventilation February-11

Section 4 - Cardiac

Section Description Revision Date
4.01 Chest Pain Acute Coronary Syndrome Mar-22
4.02 Asystole December-22
4.03 Atrial Fibrillation Atrial Flutter April-20
4.04 Pulseless Electrical Activity (PEA) January-16
4.05 Premature Ventricular Contractions (PVC) May-12
4.06 Supraventricular Bradycardia and AV Blocks April-24
4.07 Supraventricular Tachycardia January-20
4.08 Ventricular Fibrillation Pulseless Ventricular Tachycardia December-16
4.09 Ventricular Tachycardia with a Palpable Pulse July-12
4.10 Wide Complex Tachycardia Uncertain Origin January-20
4.11 Acute Cardiogenic Pulmonary Edema Pneumonia March-09
4.12 Code Cool Post ROSC Induced Hypothermia March-09
4.13 Adult Immediate Post-Cardiac Arrest Care April-12
4.14 Ventricular Assist Devices March-22

Section 5 - Medical

Section Description Revision Date
5.01 Acute Abdominal Pain April-16
5.02 Allergic Reaction Anaphylactic Shock March-19
5.03 Altered Mental Status (AMS) April-17
5.04 Suspected Stroke or Transcient Ischemic Attack May-24
5.05 Drug Overdose Poisoning March-09
5.06 Cold Emergencies April-12
5.07 Heat Emergencies August-15
5.08 Hazardous Materials July-22
5.09 Severe Hypertension March-09
5.10 Hypo or Hyperglycemia April-16
5.11 Psychological Behavioral Emergencies March-09
5.12 Seizure April-16
5.13 Non-Hemorrhagic Shock October-18
5.14 Sickle Cell Anemia Crisis March-09
5.15 Syncope March-09
5.16 Vertigo March-09
5.17 Sepsis Septic Shock Jan-24
5.18 Suspected Kidney Stone April-16
5.19 Cyanide Poisoning April-16
5.20 Excited Delirium or Drug Induced Agitation November-17
5.21 Ebola Virus Disease Patient Management October-14
5.22 Acute Adrenal Insufficiency June-18
5.23 CORE Opioid Addiction Recovery October-24

Section 6 - Trauma

Section Description Revision Date
6.01 Animal Bites Stings August-18
6.02 Burns - Thermal, Electrical, Chemical March-09
6.03 Selective Spinal Immobilization August-14
6.04 Chest Injuries March-09
6.05 Decompression Sickness or Dysbarism March-09
6.06 Extremity Injuries January-24
6.07 Head Injuries September-24
6.08 Near Drowning March-09
6.09 Ophthalmic Injuries March-09
6.10 Suspected Abuse Neglect March-09
6.11 Suspected Sexual Assault March-09
6.12 Trunk Penetrating Injuries January-24
6.13 Hemorrhagic Shock October-18

Section 7 - Pediatric and Obstetrical

Section Description Revision Date
7.01 Pediatric Asystole April-16
7.02 Pediatric Pulseless Electrical Activity PEA April-16
7.03 Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia April-16
7.04 Pregnancy Induced Hypertension (PIH) April-20
7.05 Preterm Labor November-17
7.06 Emergency Childbirth November-17
7.07 Childbirth Complications November-17
7.08 Newborn Care April-16
7.09 Post Partum Care November-17
7.10 Pediatric Febrile Emergency April-16
7.11 Vaginal Bleeding March-09
7.12 Trauma In Pregnancy March-09

Section 8 - Medication Guidelines

INTRODUCTION The following pages contain guidelines for the medications commonly encountered by the Paramedic. They identify the name and class of the drug, a short description, indications, contraindications, precautions, and dosages. This is only a guideline to medication administration and shall not circumvent the need to refer to the appropriate Standing Order or to contact Medical Control for orders and consultation. For detailed and extensive information on each drug, refer to the Physician's Desk Reference, the Advanced Cardiac Life Support text or an emergency pre-hospital pharmacology reference.

Certain medications listed have various dosages depending on the patient's condition. Refer to the appropriate Standing Order or contact Medical Control for specific dosage information. All IV piggyback medications must be placed on a micro-gtt. solution set for field administration and if available, an infusion pump or infusion regulator MUST BE UTILIZED.

The following medications are authorized to be administered by Seminole County EMS:

Medication Name Revision Date
Acetaminophen March-09
Adenosine January-20
Albuterol April-16
Amiodarone July-17
Ancef January-24
Aspirin March-09
Atropine July-17
Atrovent April-16
Calcium Chloride April-16
Cardizem July-17
Cyanokit April-16
Dextrose 10% April-16
Dextrose 50% April-16
Diphenhydramine April-16
Dopamine April-16
Epinephrine April-16
Flumazenil April-16
Geodon April-16
Glucagon April-16
Hypertonic (3%) Saline September-24
Keppra September-24
Ketamine November-20
Lasix April-16
Lidocaine July-17
Magnesium Sulfate April-16
Morphine Sulfate November-16
Naloxone April-16
Nitro Drip April-17
Nitro Spray April-17
Nitro Tablets April-17
Nitrous Oxide November-16
Oxygen March-09
Pepcid April-16
Pontocaine November-17
Promethazine April-16
Racemic Epinephrine April-16
Sodium Bicarbonate April-16
Solu-Medrol January-17
Toradol August-24
TXA October-20
Xopenex April-16
Valium April-16
Versed April-16
Zofran April-16
Medication Infusion Tables March-09

Section 9 - Procedure Guidelines

Section Description Revision Date
9.00 Lucas Device November-21
9.01 Autovent March-09
9.02 Blood Alcohol Draw on Scene March-18
9.03 Blood Draw using Vacutainer Tubes March-09
9.04 Blood Glucose Test March-09
9.05 Buretrol Usage March-09
9.06 Cardiac Monitor April-12
9.07 Cardioversion March-09
9.08 Continuous Positive Airway Pressure Device March-09
9.09 Cricothyrotomy Needle March-09
9.10 Cricothyrotomy Surgical March-09
9.11 Defibrillation March-09
9.12 Defibrillation Pediatric March-09
9.13 End Tidal CO2 Monitoring and Capnography March-09
9.14.1 Intraosseous Infusion - Femoral February-15
9.14.2 Intraosseous Infusion - Humeral Head December-16
9.15 Intubation Endotracheal March-09
9.16 Intubation Nasotracheal March-09
9.17 IVAC Medsystem III MultiChannel Infusion Pump March-09
9.18 King Tube March-09
9.19 Medication Administration Intramuscular March-09
9.20 Medication Administration Nasal Atomizer March-09
9.21 Medication Administration Nebulizer March-09
9.22 Medication Administration Subcutaneous March-09
9.23 Nasogastric/Orogastric Tube March-09
9.24 Oxygen Administration March-09
9.25 Peripheral IV Administration March-09
9.26 Pleural Decompression March-09
9.27 Removal of Taser Probes March-09
9.28 Reconstitution of Medications March-09
9.29 ResQPOD Impedance Threshold Device March-09
9.30 Transcutaneous Pacing Procedure March-09
9.31 ResQGuard Impedance Threshold Device April-11
9.32 Emergency Chest Wall Escharotomy April-11
9.33 Venous Lactate Monitoring Procedure May-12
9.34 Central Venous Access Devices June-12
9.35 Medication Administration Cross Check Jun-12
9.36 Combat Application Tourniquet Jan-14
9.37 Zoll LifeVest Wearable Defibrillator Dec-14
9.38 iTClamp Hemorrhage Control System Feb-15
9.39 I-gel Supraglottic Airway February-24
9.40 T-POD Pelvic Stabilization Device Sept-23
9.41 Controlled Substance Disposal Procedures Mar-24
9.42 LifeVac Oct-24

Section 10 - References

Section Description Revision Date
10.01 Abbreviations March-09
10.02 Apgar Score March-09
10.03 Glasgow Coma Score March-09
10.04 Pediatric Vital Signs March-09
10.05 Adult Trauma Alert Criteria March-09
10.06 Pediatric Trauma Alert Criteria March-09
10.07 Pediatric Trauma Score March-09
10.08 Nitroglycerin Drip March-09
10.09 Checking Range of Motion March-09
10.10 Rule of Nines March-09
10.11 Florida Statutes March-09
10.12 Evaluation and Treatment Flow Chart March-09
10.13 Spinal Injury Assessment Critical Criteria March-09
10.14 Celox Gauze Powerpoint April-12
10.15 Sepsis and Venous Lactate Powerpoint April-12
10.16 LVAD EMS Guide Sept-18
10.16.1 HeartMate III LVAD - Green Sept-18
10.16.2 HeartMate II LVAD - Red Sept-18
10.16.3 HeartWare LVAD - Dark Blue Sept-18
10.16.4 Jarvik 2000 LVAD - Lavendar Sept-18
10.16.5 Thoratec LVAD - Light Blue Sept-18
10.16.6 DuraHeart LVAD - Purple Sept-18
10.16.7 Total Artificial Heart LVAD - Pink Sept-18

Section 11 - Medical Director Memos

Subject Effective Date
Memo - Hurricane Ian – EMS OPERATIONS 2022-09-28
Memo - Masks Required in ED's 2022-08-22
Memo - QA/QI Program 2022-03-21
Memo - Additional EMS Skills 2020-09-01
Memo - Transport of SEPSIS Patients to Freestanding ED's 2020-07-15
Clarification on Destination Choices 2019-11-14
Transport to the OD Hospital – Advent Health Altamonte Clarification 2019-11-07
Transport to the OD Hospital – Advent Health Altamonte 2019-11-04
Further clarification on Advent Health OD Facility 2019-08-26
Transporting of Overdose Patients to AdventHealth Altamonte 2019-08-12
EMS Reports on Lift Assists 2019-03-01
Blood Draws - Nurses refusing tubes 2018-08-23
Clarification of Baker Act patients transported by EMS 2018-04-11
Opening of Oviedo Medical Center 2017-01-29
Blood Draws - Florida Hospital 2017-01-25
Medical Alerts 2016-04-27
Florida Hospital East Pediatric ED 2015-11-23
Discontinuation of Central Venous Access 2013-08-03
Shortage of Atropine 2013-04-11
EMS Blood Draws for SSCH 2013-03-07
Respiratory/Breathing Treatments 2012-12-19
OB Transports 2011-01-14
Aspirin Administration Documentation 2010-12-01
Transport of Psychiatric Patients 2010-05-17
Alert Terminology 2010-05-06
Transport of STEMI Patients 2010-03-19
Aircare Update 2010-03-19
Delayed Offloads with Critical or Unstable Patients 2010-02-25
Transport of STEMI Patients 2010-02-19
Response to Physicians Offices 2009-10-14
Patient Reports Being Given to Hospitals 2009-09-23
Patient Medications 2009-07-20
H1N1 Update 2009-06-24
Multiple Patient Refusal - Wording 2009-06-04
Request for Call Reviews 2009-05-14
H1N1 Update 2009-05-05
Clarification on Selection for Spinal Immobilization 2009-04-30
EKG Strips 2009-04-23
Patient Medications 2009-04-23
Leaving run reports at the E.R. 2009-02-03
Hyperbaric Chamber at CFRH 2008-10-16
Stemi Transport Destinations 2008-07-22
STEMI Alerts to Winter Park Hospital 2008-02-04
Documentation of Medications 2005-01-27

Section 12 - Paramedic Clinical Assessment Program

Section Description Revision Date
12.01 PCAP Guidelines Jan-19
12.02 ALS Contact Form June-10
12.03 Evaluation Form - Equip Jan-13
12.04 Evaluation Form - Protocols Jan-13
12.05 ALS Contact Definition June-10
12.06 Daily Performance Eval Sept-17
12.07 MD Meetings Roster May-13
12.08 Mentor Evaluation May-13
12.09 Verification of EMT Skills May-13
12.10 PCAP Completion Checklist Sept-17
12.11 Verification of Paramedic Skills May-13
12.12 ALS Contact Form Example 1 Dec-14
12.13 ALS Contact Form Example 2 Dec-14
12.14 Incapacitated Patient Management Dec-14

Section 13 - COVID-19

Section Description Revision Date
13.01 MD Memo - Please use Common Sense 2020-03-13
13.02 Hospital Screening and Procedures 2020-03-26
13.03 Dispatch Screening and Procedures 2020-04-01
13.04 Strict Respiratory Precautions Question Card 2020-04-01
13.05 American Red Cross Changed Response Procedures 2020-03-31
13.06 Clearance of COVID Positive, symptomatic and or exposed individuals from our previous advice 2020-07-15
13.07 Updated COVID Transport to FSED 2020-07-20


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