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===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. | | 1.05 || [[Initiation of CPR and Determination of Death]] || July-16 || | ||
|- | |- | ||
| 1. | | 1.06|| [[Determination of Death in Trauma]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.07|| [[Crime or Unattended Death Scene]] || March-09 || | ||
|- | |- | ||
| 1. | | 1.08|| [[Medical Evaluation of Person in Police Custody]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.09|| [[Trauma Transport Protocol]]|| February-19 || | ||
|- | |- | ||
| 1. | | 1.10|| [[Emergency Transport]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.11|| [[Criteria for Helicopter Transport]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.12|| [[Medical Patient Transport Decision]]|| April-14 || | ||
|- | |- | ||
| 1. | | 1.13|| [[Obstetrical Patient Transport Decision]]|| October-20 || | ||
|- | |- | ||
| 1. | | 1.14|| [[Emergency Inter Facility Transport]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.15|| [[EMS Saturation Disaster Response Levels]]|| April-16 || | ||
|- | |- | ||
| 1. | | 1.16|| [[EMS Offload Policy]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.17|| [[EMT and Paramedic County Certification Procedure]]|| July-23 || | ||
|- | |- | ||
| 1. | | 1.18|| [[EMS Quality Improvement Program]]|| March-09 || | ||
|- | |- | ||
| 1. | | 1.19|| [[Post Exposure Prophylaxis (PEP)]]|| November-21 || | ||
|- | |- | ||
| 1. | | 1.20|| [[Scope of Practice]]|| July-23 || | ||
|- | |- | ||
| 1. | | 1.21|| [[Freestanding ED Transport Criteria]]|| April-23 || | ||
|- | |- | ||
| 1. | | 1.22|| [[Hospital Capability Chart - DRAFT|Hospital Capability Chart]]|| May-24 ||May-24 | ||
|- | |- | ||
| 1. | | 1.23|| [[Documentation Guidance]]|| June-24 ||June-24 | ||
|- | |- | ||
| 1. | | 1.24|| [[School Medication Authorization Forms]]|| June-18 || | ||
|} | |} | ||
===Section 2 - Primary Care=== | ===Section 2 - Primary Care=== | ||
{| class="wikitable" | {| class="wikitable" | ||
|- | |- | ||
Line 56: | 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]]|| | |2.02 ||[[Initial Trauma Assessment and Care]]||September-17 | ||
|- | |||
||2.03 ||[[Rapid Trauma Assessment, Focused History and Physical Exam]]||Sept-15 | |||
|- | |- | ||
||2. | ||2.04||[[Analgesia and Sedation]]||December-20 | ||
|- | |- | ||
||2. | ||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]]|| | | 3.01|| [[Acute Asthma or COPD with Wheezing]]|| February-19 | ||
|- | |- | ||
| 3.02|| [[Carbon Monoxide Inhalation]]|| | | 3.02|| [[Carbon Monoxide Inhalation]]|| June-19 | ||
|- | |- | ||
| 3.03|| [[Foreign Body Airway Obstruction]]|| | | 3.03|| [[Foreign Body Airway Obstruction]]|| October-24 | ||
|- | |- | ||
| 3.04|| [[Infectious Upper Airway Obstruction - Croup or Epiglottitis]]|| | | 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 | | 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]]|| | |4.01 || [[Chest Pain Acute Coronary Syndrome]]||Mar-22 | ||
|- | |- | ||
|4.02 || [[Asystole]]|| | |4.02 || [[Asystole]]||December-22 | ||
|- | |- | ||
|4.03 || [[Atrial Fibrillation Atrial Flutter]]|| | |4.03 || [[Atrial Fibrillation Atrial Flutter]]||April-20 | ||
|- | |- | ||
|4.04||[[Pulseless Electrical Activity (PEA)]]|| | |4.04||[[Pulseless Electrical Activity (PEA)]]||January-16 | ||
|- | |- | ||
|4.05||[[Premature Ventricular Contractions (PVC)]]|| | |4.05||[[Premature Ventricular Contractions (PVC)]]||May-12 | ||
|- | |- | ||
|4.06||[[Supraventricular Bradycardia and AV Blocks]]|| | |4.06||[[Supraventricular Bradycardia and AV Blocks]]||April-24 | ||
|- | |- | ||
|4.07||[[Supraventricular Tachycardia]]|| | |4.07||[[Supraventricular Tachycardia]]||January-20 | ||
|- | |- | ||
|4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]|| | |4.08||[[Ventricular Fibrillation Pulseless Ventricular Tachycardia]]||December-16 | ||
|- | |- | ||
|4.09||[[Ventricular Tachycardia with a Palpable Pulse]]|| | |4.09||[[Ventricular Tachycardia with a Palpable Pulse]]||July-12 | ||
|- | |- | ||
|4.10||[[Wide Complex Tachycardia Uncertain Origin]]|| | |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]]|| | |5.01||[[Acute Abdominal Pain]]||April-16 | ||
|- | |- | ||
|5.02||[[Allergic Reaction Anaphylactic Shock]]||March- | |5.02||[[Allergic Reaction Anaphylactic Shock]]||March-19 | ||
|- | |- | ||
|5.03||[[Altered Mental Status (AMS)]]|| | |5.03||[[Altered Mental Status (AMS)]]||April-17 | ||
|- | |- | ||
|5.04||[[Suspected Stroke Transcient Ischemic Attack TIA]]|| | |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||[[ | |5.06||[[Cold Emergencies]]||April-12 | ||
|- | |- | ||
|5.07||[[ | |5.07||[[Heat Emergencies]]||August-15 | ||
|- | |- | ||
|5.08||[[Hazardous Materials]]|| | |5.08||[[Hazardous Materials]]||July-22 | ||
|- | |- | ||
|5.09||[[Severe Hypertension]]||March-09 | |5.09||[[Severe Hypertension]]||March-09 | ||
|- | |- | ||
|5.10||[[Hypo or Hyperglycemia]]|| | |5.10||[[Hypo or Hyperglycemia]]||April-16 | ||
|- | |- | ||
|5.11||[[Psychological Behavioral Emergencies]]||March-09 | |5.11||[[Psychological Behavioral Emergencies]]||March-09 | ||
|- | |- | ||
|5.12||[[Seizure]]|| | |5.12||[[Seizure]]||April-16 | ||
|- | |- | ||
|5.13||[[Shock]]|| | |5.13||[[Non-Hemorrhagic Shock]]||October-18 | ||
|- | |- | ||
|5.14||[[Sickle Cell Anemia Crisis]]||March-09 | |5.14||[[Sickle Cell Anemia Crisis]]||March-09 | ||
Line 148: | Line 169: | ||
|5.16||[[Vertigo]]||March-09 | |5.16||[[Vertigo]]||March-09 | ||
|- | |- | ||
|5.17||[[Sepsis Septic Shock]]|| | |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. | |5.21||[[Ebola Virus Disease Patient Management]]||October-14 | ||
|- | |- | ||
|5. | |5.22||[[Acute Adrenal Insufficiency]]||June-18 | ||
|- | |- | ||
|5. | |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]]|| | |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]]|| | |6.03||[[Selective Spinal Immobilization]]||August-14 | ||
|- | |- | ||
|6.04||[[Chest Injuries]]||March-09 | |6.04||[[Chest Injuries]]||March-09 | ||
Line 172: | Line 202: | ||
|6.05||[[Decompression Sickness or Dysbarism]]||March-09 | |6.05||[[Decompression Sickness or Dysbarism]]||March-09 | ||
|- | |- | ||
|6.06||[[Extremity Injuries]]|| | |6.06||[[Extremity Injuries]]||January-24 | ||
|- | |- | ||
|6.07||[[Head Injuries]]|| | |6.07||[[Head Injuries]]||September-24 | ||
|- | |- | ||
|6.08||[[Near Drowning]]||March-09 | |6.08||[[Near Drowning]]||March-09 | ||
Line 183: | 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]]|| | |7.01||[[Pediatric Asystole]]||April-16 | ||
|- | |- | ||
|7.02||[[Pediatric Pulseless Electrical Activity PEA]]|| | |7.02||[[Pediatric Pulseless Electrical Activity PEA]]||April-16 | ||
|- | |- | ||
|7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]|| | |7.03||[[Pediatric Ventricular Fibrillation or Pulseless Ventricular Tachycardia]]||April-16 | ||
|- | |- | ||
|7.04||[[Pregnancy Induced Hypertension (PIH)]]|| | |7.04||[[Pregnancy Induced Hypertension (PIH)]]||April-20 | ||
|- | |- | ||
|7.05||[[Preterm Labor]]|| | |7.05||[[Preterm Labor]]||November-17 | ||
|- | |- | ||
|7.06||[[Emergency Childbirth]]|| | |7.06||[[Emergency Childbirth]]||November-17 | ||
|- | |- | ||
|7.07||[[Childbirth Complications]]|| | |7.07||[[Childbirth Complications]]||November-17 | ||
|- | |- | ||
|7.08||[[Newborn Care]]|| | |7.08||[[Newborn Care]]||April-16 | ||
|- | |- | ||
|7.09||[[Post Partum Care]]|| | |7.09||[[Post Partum Care]]||November-17 | ||
|- | |- | ||
|7.10||[[Pediatric Febrile Emergency]]|| | |7.10||[[Pediatric Febrile Emergency]]||April-16 | ||
|- | |- | ||
|7.11||[[Vaginal Bleeding]]||March-09 | |7.11||[[Vaginal Bleeding]]||March-09 | ||
Line 216: | Line 251: | ||
===Section 8 - Medication Guidelines=== | ===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" | {| 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=== | ===Section 9 - Procedure Guidelines=== | ||
{| class="wikitable" | {| class="wikitable" | ||
|- | |- | ||
! Section !! Description !! Revision Date | ! Section !! Description !! Revision Date | ||
|- | |- | ||
|9.00||[[ | |9.00||[[Lucas Device]]||November-21 | ||
|- | |- | ||
|9.01||[[Autovent]]||March-09 | |9.01||[[Autovent]]||March-09 | ||
|- | |- | ||
|9.02||[[Blood Alcohol Draw on Scene]]||March- | |9.02||[[Blood Alcohol Draw on Scene]]||March-18 | ||
|- | |- | ||
|9.03||[[Blood Draw using Vacutainer]]||March-09 | |9.03||[[Blood Draw using Vacutainer|Blood Draw using Vacutainer Tubes]]||March-09 | ||
|- | |- | ||
|9.04||[[Blood Glucose Test]]||March-09 | |9.04||[[Blood Glucose Test]]||March-09 | ||
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|9.05||[[Buretrol Usage]]||March-09 | |9.05||[[Buretrol Usage]]||March-09 | ||
|- | |- | ||
|9.06||[[Cardiac Monitor]]|| | |9.06||[[Cardiac Monitor]]||April-12 | ||
|- | |- | ||
|9.07||[[Cardioversion]]||March-09 | |9.07||[[Cardioversion]]||March-09 | ||
Line 290: | Line 387: | ||
|9.12||[[Defibrillation Pediatric]]||March-09 | |9.12||[[Defibrillation Pediatric]]||March-09 | ||
|- | |- | ||
|9.13||[[End Tidal CO2 Monitoring | |9.13||[[End Tidal CO2 Monitoring and Capnography]]||March-09 | ||
|- | |- | ||
|9.14||[[Intraosseous Infusion]]|| | |9.14.1||[[Intraosseous Infusion - Femoral]]||February-15 | ||
|- | |||
|9.14.2||[[Intraosseous Infusion - Humeral Head]]||December-16 | |||
|- | |- | ||
|9.15||[[Intubation Endotracheal]]||March-09 | |9.15||[[Intubation Endotracheal]]||March-09 | ||
Line 329: | Line 428: | ||
|- | |- | ||
|9.32||[[Emergency Escharotomy|Emergency Chest Wall Escharotomy]]||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 | |||
|} | |} | ||
Line 354: | Line 473: | ||
|10.09||[[Checking Range of Motion]]||March-09 | |10.09||[[Checking Range of Motion]]||March-09 | ||
|- | |- | ||
|10.10||[ | |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 | |10.11||[[Florida Statutes]]||March-09 | ||
Line 361: | Line 480: | ||
|- | |- | ||
|10.13||[[Spinal Injury Assessment Critical Criteria]]||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 | |||
|} | |} | ||
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! Subject !! Effective Date | ! Subject !! Effective Date | ||
|- | |- | ||
| [[Memo - OB Transports|OB Transports]] || 2011-01- | | [[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 - Transport of Psychiatric Patients|Transport of Psychiatric Patients]] || 2010-05-17 | ||
|- | |- | ||
| [[Memo - Alert Terminology|Alert Terminology]] || 2010-05-06 | | [[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 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 - 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 - 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 - 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 Transport Destinations|Stemi Transport Destinations]] || 2008-07-22 | ||
Line 386: | Line 593: | ||
| [[Memo - STEMI Alerts to Winter Park Hospital|STEMI Alerts to Winter Park Hospital]] || 2008-02-04 | | [[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 | |||
|- | |- | ||
| Example || Example | |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 | |||
|} | |||
[https://forms.gle/XA7uhzLGYbwqBHTZ9 Link to MD Meeting Sign In] |
Latest revision as of 19:51, 22 October 2024
TABLE OF CONTENTS
Medical Director Authorization
Section 1 - Administrative Policies
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 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
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 |